PLATINUM HOME HEALTH CARE
Authorizations Specialist (Bilingual Spanish) (Education)
Understanding Operations: Gain a comprehensive understanding of the day-to-day operations within the Authorizations department, including procedures, policies, and workflows.
Problem Solving: Demonstrate the ability to define problems, collect data, and facilitate resolutions to issues that arise within the department.
Computer Proficiency: Perform various computer functions to support communication between departments and overall office operations.
Punctuality: Arrive punctually at the assigned start time and maintain a reliable presence in the department.
Team Participation: Actively participate in and encourage a team-oriented environment, contributing to a cohesive and productive department.
Efficiency: Maintain efficient methods to ensure that daily responsibilities are carried out routinely and in accordance with departmental standards.
Incident Reporting: Report major incidents to the Department's Lead, Director of Patient Services, and Director of Operations promptly.
Department Coverage: Be prepared to fill in for colleagues within the Authorizations Department as needed, ensuring continuity of operations.
Phone Etiquette: Answer phones in a professional and timely manner, providing information and assistance as required.
Patient Satisfaction: Monitor and address patient satisfaction, promptly reporting any patient complaints to the relevant departments for resolution.
Information Accuracy: Ensure that the Coordination Department receives accurate information when entering new cases into the system.
Compliance: Adhere to ethical practices, respecting patient and employee rights and privacy, maintaining the security of protected information, and following the agency's compliance program and privacy policies.
Additional Tasks: Complete other tasks as assigned by the Department's Lead, Director of Patient Services, and Director of Operations.
RESPONSIBILITIES:
Manage all patients' profiles, including creating profiles upon receiving new patients, following the checklist provided and updating patients' profiles as necessary when receiving new authorizations.
Enter all authorizations data into HHA Exchange with meticulous attention to detail, as well as ensure proper codes are used and verify that days and hours entered match the authorization.
Ensure accuracy between the Master Week and Authorization. Verify that Master Weeks rolls over.
Run Authorization Expired Reports as necessary. Call contracts and request expired authorizations and follow up with all requests if not received on time.
Run pre-billing for any authorization issues.
Open and check all mail correspondence for any relevant information.