Job Information
Sevita Lead Authorization Specialist in New Jersey
Mentor Community Services , a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You’ll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived.
Program Administration Authorization Supervisor
Salary:$48,000 Annually
Location: Remote, but you must live in an Eastern Time Zone. Preferably in New Jersey
Do you want to grow your leadership skills and support a team that has a background in medical administration/billing and makes a positive difference in people’s lives? As Program Administration Authorization Supervisor, you will supervise and schedule the staff that verifies, tracks, and reports consumer authorizations, including document review and data entry.
Supervises/manages eligibility and authorizations for all admissions and “unfunded” persons served
Oversees main billing system (ie. Credible) to capture service entry, admissions, discharges and transfers prior to billing
Manages a entries of consumer authorization information data into system to assist in accurate financial reporting and timely billing of services provided by local office staff.
Communicates with program staff alerting local offices of potential unauthorized sales issues.
Reviews Managed Care Authorization reports for all pending authorization requests.
Oversees and researches required authorization process by service type and payer source.
Manages complex authorization billing using local management entity based systems and Value Option Provider Connect website, Payer Portals and by phone.
Oversees documentation process which must be maintained to support authorizations and billing, to include but not limited to the printing of approved Commercial, Medicaid and Health Choice authorizations. Contacts local management entities for copies of authorization letters.
Researches and resolves authorization related billing and accounts receivable inquiries from accounting, contacting program staff, value options and local management entity as needed.
Reviews Unauthorized Sales Reports and works with local office staff on resolution of unauthorized sales items. Prepares supporting documentation for authorization related sales adjustments.
Reviews Authorization Expiration Report routinely and communicates to program staff on authorizations that are about to expire.
Maintains files of authorization information by client.
Creates training and workflow process for systematic use across states and service lines
Participates in development of system and report updates needed to create department efficiencies
Assists in the development of key performance measures used for the oversight and continuous performance improvement of department.
Performs other related duties and activities as required.
Qualifications:
Associate or Bachelor’s degree preferred
Minimum of one year of experience in the medical administration field and/or medical billing
Two years of supervisory/ management experience preferred.
Experience with a payer online portal and knowledge of EDI 835 formatting preferred
Strong Proficiency with Microsoft Word, Excel, and Outlook is required (Daily use is expected)
Detail-oriented with ability to multitask
Demonstrated skills in communication, problem-solving, and data entry
Excellent communication skills with ability to respect and build rapport with others
Commitment to excellent customer service and support
Why Join Us?
Full compensation/benefits package for employees working 30+ hours/week
401(k) with company match
Paid time off and holiday pay
Important work adding value to the organization’s mission alongside a great team of coworkers
Enjoy job security with nationwide career development and advancement opportunities
Come join our amazing team of committed, caring professionals. Apply Today!
Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.
We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.
As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.