Intake Coordinator

The Stepping Stones Group, LLC; United States; Remote; USD 45,000 - 52,000; Full time

Job summary

The Stepping Stones Group, LLC is seeking an Authorization & Eligibility Representative for Community Autism Services. This 100% remote role will involve processing eligibility and consent forms, updating client information in Central Reach, and coordinating with health plans to secure authorizations for ABA or ASD services.

You will also communicate benefits details to families, audit enrollment receipts, and collaborate with the clinical team to ensure alignment with health plan requirements.

Qualifications

• Receiving Eligibility & Consent forms from intake and checking eligibility and coverage details for ABA or ASD services.

Responsibilities

• Sending correspondence and updates to clients regarding benefits and steps to seek authorization.
• Updating client basic contact info and metadata in Central Reach.
• Creating and auditing receipts of Client Enrollments sent to family.
• Reviewing diagnostic reports and treatment plans to ensure health plan criteria are met.

Skills

Eligibility forms

Job description

Authorization & Eligibility Representative- Community Autism Services - 100% remote

TheSteppingStonesGroupistransformingthelivesofchildren,families,andcommunitiestogetherthroughourexceptionaltherapeuticandbehavioralhealthservices.WebelieveourCoreValuesembodythecultureofourorganization:Trust,Integrity,Results,Quality,Community,andInclusivity.

RoleandResponsibilities:

AdheretothecoreresponsibilitiesofmyroleasAuthorization&EligibilityRepresentative,includingbutnotlimitedto:

• ReceivingEligibility&ConsentformsfromintakeandcheckingeligibilityandcoveragedetailsformemberspursuingeitherAppliedBehaviorAnalysis(ABA)servicesorforthetreatmentofanAutismSpectrumdiagnosis(ASD)
• Sendingcorrespondenceandupdatestoclientsregardingtheirbenefitsandthestepstakentoseekauthorization,perclienthealthplanguidelines
• UpdatingclientBasicContactinfo(address,payer,claimsettings)andMetadata+pertainingclientlabelsin Central Reach
• Creating,distributing,andauditingreceiptofClientEnrollmentPacketssenttofamily
• Coordinationofbenefitsform
• ClientServicesAgreement
• CreditCardagreement
• ServiceDeliveryAgreement
• NoticeofPrivacyPractices
• Reviewingclientdiagnosticreportsandtreatmentplanstoensuretheymeethealthplanspecificcriterion;makingrecommendationsonhowtoproceediffurtherevaluationisrequired
• Preparingauthorizationrequestsforhealthinsurancecompanies
• Timelysubmission,tracking,andreviewingofauthorizationstatusandaccuracy(units/codes,authorizationdates,sessionfrequenciesforallfundingsources(Insurance/RegionalCenter/SchoolDistrict/PrivatePay))
• Receivingfeedbackfromhealthinsurancecompanycaremanagersandworkingwiththeclinicalteamtotakeanycorrectivemeasuresneededtosecureclientauthorization
• TaskingauthorizationstobeenteredintoCentralReachandverifyingauthorizationafterithasbeenentered
• Creating,distributing,andauditingreceiptofcostprojectionsforallcasesneeded
• Correspondingwiththebillingteamregardingbenefitdetaildiscrepanciesandworkingtoproposeworkablesolutions.
• Providingadministrativeback-upwhennecessary(answerphones,scanning,filing,etc.)

MakeaconcertedefforttomeetthetargetssetforthformycoreresponsibilitiesasanAuthorization&EligibilityRepresentative:

• Maintainlessthan10overduetasks
• Completetaskswithin2daysofduedate
• Clientcount

EmbodytheCoreValuesofTheSteppingStonesGroupasanAuthorization&EligibilityRepresentativeby:

• ProactivelyengagingindiscussionswithyourA&ETeammembers
• Maintainingandunrelentingfocusonimprovementandprovidingclientvalue
• Effectivelycommunicatingyourneedsandconcernstoyou'reA&ETeamleadership
• Participatinginyourone-on-onemeetingswithA&ETeamleadership
• AligningtodocumentedstandardprocessesandworkflowsandpartneringwiththeA&Eleadershipteamwhenthereisunalignmentthatrequiresresolution
• Providingpromptresponsestoinquiriesfromclients,teammembers,andleadership
• Remaining flexible as office assignments and ad hoc responsibilities may shift for business need