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Authorization Coordinator, Home Health - San Ramon, CA

Operations | San Ramon, CA | Full Time

Job Description

CVHCare, a leader in Home Health Clinical Services, headquartered in beautiful San Ramon, CA, is currently seeking a Authorization Coordinator to join our San Ramon office. This is a great opportunity to join an established leader in the California home health industry, with the freedom to put your skills and imagination to work. We deliver Compassionate Visionary Health Care, where passion and team spirit are nurtured and rewarded.

Position Summary: The Authorization Coordinator is responsible for managing all aspects of the authorization process including responding to clinician requests in a timely manner, collecting appropriate patient information from clinicians, working closely with insurance companies for approvals and tracking authorizations in process for timely completion. Effectively managing this process is vital to the flow of patient care.

Key Responsibilities:

  • Draft HMO authorization requests and submit to appropriate parties.
  • Track and follow-up on pending authorizations & orders. 
  • Authorizations received are compared to authorizations sent out, any authorizations not returned in 1-2 days are re-sent.
  • Follow up with clinicians if addition information is needed to process the authorization request. 
  • Work closely with scheduling to ensure authorized visits are being completed.
  • Communicate with Clinical Mangers regarding approval of new requests. 
  • Maintain complex electronic patient records databases (EMR). 
  • Handle high volume multi-line phones. Follow-Up calls to/from clinicians and insurance companies.
  • Administrative support for Operations team and office as needed.
  • Assisting company Officers with various projects (ranging from creating detailed Excel reports to making follow-up calls to MD offices).
  • Extensive data entry. 

Minimum Qualifications:

  • Minimum of 2 yrs. experience in a medical setting in either a patient care or administrative role.
  • Knowledge of the home care environment strongly preferred.
  • Knowledge MS Office, Suite, Internet Explorer and professional telephone protocol.
  • Basic knowledge of medical terminology 
  • Able to deliver effective results, meet tight deadlines and targets.
  • Excellent customer service and communication/interpersonal skills.
  • Ability to work with high degree of precision, paying attention to detail to achieve the high accuracy levels required and timely follow-up and close-out of all matters.
  • Ability to communicate well, both orally and in writing to minimize confusion and additional concerns.
  • Degree in Healthcare Administration or Management highly preferred.

Who We Are: CVHCare is you!

Our outstanding clinicians and staff make CVHCare the outstanding company it is today.  Our ardent commitment to delivering excellence in patient care is fully ingrained in our company culture, and this starts with our employees. With exceptional skills, passionate dedication, and outstanding values, we've become a thriving home health provider throughout the state of California. You will find that our employees enjoy working for CVHCare, rate our company and leadership highly, and value our commitment to delivering the highest quality of health care and service to our patients.

CVHCare is Compassionate, Visionary Health Care. We believe in sharing skills, knowledge and resources to develop and support the growth of our teams.

CVHCare is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at CVHCare are based on business needs, job requirements, individual qualifications, and merit….without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. CVHCare will not tolerate discrimination or harassment based on any of these characteristics.