Medical Authorizations

The Offer

• Opportunity within a company with a solid track record of performance
• Opportunity to make a positive impact
• Leadership Role

The Job

Consider yourself a Medical Authorization & Billing Whiz Kid? Are you an expert using Availity and Office Ally or other claims processing software? Are you adept at transforming complex billing processes into smooth, efficient operations? Can you communicate clearly and effectively with clients and teammates? Rooted Life is on the lookout for a Authorization & Billing Specialist like you Join us and become an integral part of a team that navigates the intricate world of healthcare billing and authorization with precision and care. In this role, you'll be the linchpin in our financial workflow, turning billing challenges into triumphs with your expertise and dedication

Who We’re Looking For:

Are you ready to be more than just a cog in the machine? At Rooted Life, we're seeking dynamic individuals who are not just task performers but true leaders in their roles. We are looking for a visionary who is ready to innovate and inspire, responsible for ensuring a patient's visit is financially secured. This role requires proficient communication and the ability to handle insurance verification, notification, and authorization, as well as communicating patient financial responsibilities and other patient access operational activities. Ideal candidates are:

• Authorization Expert: Brings extensive experience in insurance verification, prior-authorization, and team coordination.
• Extremely Organized: Able to manage complex processes and maintain meticulous records.
• Collaborative Communicator: Proficient in working across departments to gather and analyze client information, ensuring effective authorization and billing records.
• Process Developer: Experienced in creating smooth, efficient intake and authorization processes from start to finish.
• Excellent English: Must possess superb command of English, both written and spoken, to ensure clear and effective communication to effectively liaise with stakeholders in the region.

What You'll Be Doing:

This is not your standard medical authorizations & billing job. We are looking for someone who is a workflow and process expert, capable of building and implementing efficient process around authorizations and billing through our EHR. This role involves a limited range of codes but requires a deep understanding of workflow optimization.

Responsibilities include:

• Data Accuracy: Collects and reviews patient demographic and insurance data as part of the authorization process.
• Documentation Management: Collects and submits all necessary documentation and diagnoses needed for authorizations.
• Follow-Up Expert: Provides daily updates on the status of authorization requests to ensure optimum service delivery.
• Reimbursement Maximiser: Focused on ensuring maximum reimbursement through meticulous billing and coding for all services rendered.
• Claims Specialist: Manages the full claims process in our EHR, from creation to follow-up, handling insurance inquiries with expertise.
• HIPAA Guardian: Upholds the strictest confidentiality and adheres to all HIPAA regulations.
• Insurance Liaison: Confirms and documents the patient's health insurance details, including effective dates, network status, and coverage requirements.
• Problem Solver: Utilizes problem-solving skills to address any issues arising from insurance coverage or prior authorizations.
• Knowledge Maintainer: Keeps updated with contract limitations and details for each Managed Care Plan (MCP) and stays informed about the services and programs offered by Rooted Life.
• Note: We will not consider applicants without specific experience in creating and managing efficient billing processes. Please do not contact directly.

The Profile

• You have at least 5 years experience within a Authorizations and/or Medical Billing role, within the Healthcare industry
• You have working knowledge of Medical Billing, Revenue Cycle Management (RCM) and Insurance Authorizations and have developed processes in one or all of these areas
• You possess strong analytical skills and are comfortable dealing with numerical data
• You are highly goal driven and work well in fast paced environments
• You pay strong attention to detail and deliver work that is of a high standard
• Knowledge of insurance verification, prior-authorization, and office coordination

The Employer

Our client is a compassionate and innovative organization operating in California, dedicated to aiding those experiencing homelessness, recovering from hospital stays, or facing housing challenges. Their mission is to guide individuals through the journey of finding and securing safe, stable homes. They provide essential services including financial assistance for initial housing costs and ongoing support to maintain stable living situations.