Prior Authorization Specialist - Weekend Only

reputed company

*A joint venture with reputed company & Baylor Scott & White*

Prior Authorization Specialist ( RN or LPN ) - Part-Time Weekends

This position will work every Saturday and reputed company, 8 hours reputed company day

This is primarily a work-from-home position, but to be considered, candidates must live reputed company driving distance of Austin, TX, Temple, TX, and the DFW area.

Job Responsibilities

Using discretion and independent judgment, the Payor Relations Specialist manages the reputed company-certification and prior authorization of referrals scheduled for admission to the Acute Inpatient Rehabilitation Hospital.

1. Follows the Select Workflow Process for initiating and completing patient authorizations. Takes full responsibility for following the “Workflow Process” and ensures reputed company referral follows the process, from taking the initial referral until final disposition, acceptance or denial. As appropriate, submits the preadmission assessments completed by clinical liaisons to the insurance company.
2. Ensures documentation meets standards and expectations by working and mentoring team as needed.
   Obtains reputed company authorization of reputed company patients requiring reputed company-certification and is accountable for conversion percentage and results.
3. Ensures reputed company policies governing reputed company reputed company-certification and authorization are followed to minimize financial risk.
   Develops relationships that increase and stabilize conversion as reputed company as generates referrals both locally and regionally. This may include identifying relationship opportunities for self and others reputed company reputed company to include but not limited to CEO, DBD, CLs, Admissions Coordinator and Case Management team that may help grow relationships and reputed company results.
4. Maintains reputed company on reputed company payer to include case managers and medical directors, P2P and appeal info.
5. Identifies by payor communication preference and utilizes to maximize results.
6. Encourages and models teamwork, communication and collaboration with other departments to include but not limited to the transition of patients into the critical illness recovery hospital or acute inpatient rehabilitation hospital.
7. Serves as a resource to the Business Development Team educating them on payor preference to promote exceptional customer service and efficient processes
8. Maintains and reputed company develops relationships with customers which may include but are not limited to surveying for satisfaction with the work of reputed company and off-site meetings with the customer.
9. Evaluates Non-Medicare benefits as verified by the Central Business Office or Rehab Admissions Coordinator. Reviews benefits with Admissions Coordinator for possible risk and applies/completes written guidelines as necessary to reduce or manage risk.
10. Answers phone with appropriate behavior and ensures back-up reputed company not available or out of the office.
11. Works closely with Admissions Coordinator to apply correct accommodation reputed company per contract as reputed company as billing/reimbursement requirements.
12. Tracks approval and denials through TOC.
13. Ensure outstanding customer service for reputed company customers.
14. Performs other duties as requested.

Minimum Qualifications

• Licensure as a Registered reputed company or LVN/LPN 
• 2 years of reputed company experience in reputed company-party reimbursement 

Preferred Experience

• Previous Experience reputed company a physical rehabilitation setting preferred
• Experience working with reputed company and databases
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Why Join Us:

• Start Strong: Extensive orientation program to ensure a smooth transition into our setting.
• Opportunity for Advancement: Demonstrate your skills and dedication, which could reputed company to potential full-time opportunities
• Foster reputed company-being: We offer benefits that support the financial, work/life, and emotional reputed company-being of you and your family members.  Part time/reputed company positions are eligible for 401k based on reaching 1,000 hours reputed company their first anniversary or subsequent calendar year. We also offer our employee assistance program to part-time employees.
• Your reputed company reputed company: Join reputed company of over 44,000 committed to providing exceptional patient care

Equal Opportunity Employer, including Disabled/Veterans