Managed Care Authorization Specialist

Vancouver Support Office (VSO); California (MO); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Competitive Pay

Health, Dental, Vision Insurance

Generous PTO Package

Employee Assistance Program

Training & Development Opportunities

Job summary

Evergreen Healthcare Group is seeking an experienced Managed Care Authorization Specialist to join our corporate team. You will manage concurrent authorization requests, coordinate with payers and facility staff, and support with initial authorization requests as needed.

Responsibilities include data entry into EMR for billing, insurance verification with admissions teams, and maintaining up-to-date knowledge of reimbursement rules. Excellent communication in English required.

Qualifications

• Maintains patient confidentiality and regulatory compliance.
• Proficient with Microsoft Office and EMR software.
• Excellent written and verbal English communication.

Responsibilities

• Data entry of patient information into the EMR for billing.
• Collaborates with Admissions for insurance verification and case management.
• Maintains knowledge of reimbursement principles and pricing parameters.
• Communicates with payor case managers for updates/authorizations.
• On-call responsibilities as assigned.
• Handles client complaints promptly and empathetically.
• Trains new hires and performs remedial training.
• Manages and monitors to-dos in EMR daily.
• Assists Supervisor with projects as assigned.

Skills

Regulatory compliance

Confidentiality

Communication skills

Time management

Education

High school diploma or equivalent

Tools

Microsoft Office

Excel

Word

PowerPoint

Outlook

Job description

Managed Care Authorization Specialist

Job Summary:

Evergreen Healthcare Group is seeking an experienced and dedicated Managed Care Authorization Specialist to join our team our corporate team. As a key member support team, you will manage concurrent authorization requests and tracking; communicate effectively with peers, payers, and facility staff to confirm efficient delivery of information; and assist with initial authorization requests as needed.

Responsibilities:

• Data entry of patient information into the electronic medical record for patient billing.

• Collaborates with Admissions Teams for insurance verification and case management negotiations for patient/payer set ups.

• Maintains knowledge of reimbursement principles and pricing parameters.

• Provides and documents ongoing communication with payor case managers for updates/changes/authorizations.

• Recognizes and notifies supervisor of potential problem referrals.

• Available for on-call responsibilities as assigned.

• Handles client complaints in a fair and empathetic manner.

• Trains new hires and performs remedial training with current staff.

• Manages and monitors “to-dos” in Electronic Medical Record daily.

• Assists Supervisor with projects as assigned.

OTHER DUTIES

• Completes annual education requirements.

• Communicates the mission, ethics, and goals of the organization.

• Attends annual review and performs departmental in-services.

KNOWLEDGE, SKILLS, AND ABILITIES

• Ability to maintain patient confidentiality.

• Ability to maintain regulatory requirements, including federal, state, local regulations, and accrediting organization standards.

• Excellent computers skills and application experience within a professional level Microsoft; advanced Excel, Word, Power Point, and Outlook skills required.

• Regularly attend and be punctual for scheduled shift and be in a condition suitable to perform duties of position.

• Ability to organize and prioritize work, use time efficiently, and complete work in a timely matter, guaranteeing that deadlines are met.

• Works at maintaining a good rapport and a cooperative working relationship with physicians, departments, and staff.

• Able to communicate effectively in English, both verbally and in writing.

EDUCATION, LICENSURE, AND EXPERIENCE

• High school diploma or equivalent.

• Managed Care Insurance Verification and Health Care experience required, Medical Terminology desired.

• Three years’ experience of Managed Care Insurance Verification and Health Care experience, Health Information ot Admission/Intake services is preferred.

• Electronic medical record documentation experience preferred.

What We Offer

• Competitive Pay

• Health, Dental, Vision Insurance

• Generous PTO Package

• Employee Assistance Program

• Training & Development Opportunities

At Evergreen, we believe in creating a culture that values compassion, accountability, and growth for both our residents and our team members. If you're ready to bring your skills to a role where they truly matter, we’d love to hear from you!

Evergreen Healthcare Groupis an equal opportunity employer.