[Hiring] Authorization Specialist Lead II @Hartford HealthCare at Home

Role Description

The Home Health and Hospice Authorization Specialist Lead 2 entails supporting the Prebilling and Authorization Manager in various tasks including:

• Training and payor updates
• Identifying metrics around eligibility and authorizations
• Ensuring accurate and timely processing of patient insurance verifications and prior authorization requests
• Reviewing submitted information and resolving complex cases
• Maintaining quality standards within established payor guidelines

The position requires strong knowledge of payor contracts, insurance authorization requirements, and excellent communication skills to effectively interact with branches, team members, and payors. Key responsibilities include:

• Verifying insurance eligibility and authorization requirements for Home Health and Hospice clients
• Communicating payor eligibility and authorization information to necessary parties
• Working independently as well as within a team environment
• Assisting in identifying Quality Assurance Reviews (QARs) upon request
• Performing other related duties as assigned by the Prebilling and Authorizations Manager

The Authorization Specialist Lead 2 is part of a fully remote team with the possibility of being onsite as needed.

Qualifications

• Education: High School Diploma required
• Experience:
  • One year of experience within a healthcare setting and familiarity with payor sources and processes required
  • Two to four years’ experience within a healthcare setting preferred
• Language Skills: Strong written and verbal English communication skills are necessary
• Knowledge of third party payor regulations including Medicare, Assistance, Veterans Affairs (VA), and private insurance
• Ability to promote and maintain a positive attitude
• Strong organizational skills and the ability to work independently with minimal supervision
• Basic computer skills with the ability to learn new software
• Knowledge of Word and Excel a plus

Requirements

• Ability to make appropriate judgments related to the payor authorization process
• Demonstrates strong organizational skills
• Ability to work independently with minimal supervision

Benefits

• Competitive benefits program designed to ensure work/life balance
• Opportunities for career development and growth