Regional Authorization Specialist Medical Billing

Profile

u003cpu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental health services to adults with serious mental illness. We partner with public sector entities and behavioral health organizations and have over 145 programs and over 4,300 employees across the country. And weu0027re growing all the time! When you work at Telecare, you help to empower thousands of individuals every day in their journeys of recovery.u003cstrongu003eu0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eu003cstrongu003eTelecare is proud to have been recognized by The Bay Area Business Times as the 9u003csupu003ethu003c/supu003e Best Place To Work In the Bay Area for 2020! This is the 18th time we have made the list!u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eOur Corporate Headquarters has over 250 employees in following departments:u0026nbsp; Executive, Development, Finance, Information Systems, Human Resources, Operations, and Marketing u0026amp; Operations.u003c/pu003enu003cpu003eu003cstrongu003eEmployment Status:u003c/strongu003eu0026nbsp; Full-Timeu003c/pu003enu003cpu003eu003cstrongu003eShift:u003c/strongu003eu0026nbsp; Days, 8:30 am u0026ndash; 5:00 pmu003c/pu003enu003cpu003eu003cstrongu003eDays:u003c/strongu003eu0026nbsp; Monday - Fridayu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003ePOSITION SUMMARYu003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cspanu003eThe Regional Authorization Specialist position is responsible for requesting, tracking, follow up and data entry into the electronic health record for all authorizations, including but not limited to Medi-Cal/Medicaid, Managed Medicaid and commercial insurance plans for all assigned programs in the region.u003cspanu003eu0026nbsp; u003c/spanu003ePosition is the liaison between the programs and the Corporate Revenue Cycle Department. u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eQUALIFICATIONSu003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eRequired: u003c/spanu003eu003c/strongu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eHigh School Graduation or G.E.D.u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eFive (5) years professional experience in a healthcare facility u003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eType 40 WPM or moreu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAbility to read, write, and speak Englishu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eStrong analytical and time management skills and attention to detailu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAbility to understand complex reimbursement structures and governmental regulationsu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAbility to work and communicate effectively with customers, government representatives, management and staffu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eProfessional knowledge of Medicare, Medi-Cal/Medicaid, Managed Medicaid, managed care health plans and commercial insurance plansu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eKnowledge of u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eu003cspanu003eu003cspanu003eCPT and HCPCS codes and medical terminologyu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eMust be at least 18 years of ageu003c/spanu003eu003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eMust be CPR, Crisis Prevention Institute (CPI), and First Aid certified on date of employment or within 60 days of employment and maintain current certification throughout employment u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAll opportunities at Telecare are contingent upon successful completion and receipt of acceptable results of the applicable post-offer physical examination, 2-step PPD test for tuberculosis, acceptable criminal background clearances, excluded party sanctions, and degree or license verification. If the position requires driving, valid driver license, a motor vehicle clearance and proof of auto insurance is required at time of employment and must be maintained throughout employment. Additional regulatory, contractual or local requirements may applyu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003ePreferred:u003c/spanu003eu003c/strongu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eTwo (2) or more years of collegeu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eExperience in behavioral health organizationu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eESSENTIAL FUNCTIONSu003c/spanu003eu003c/strongu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eDemonstrate the Telecare mission, purpose, values and beliefs in everyday language and contact with the internal and external stakeholdersu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAssists in developing the overall philosophy and objectives of the Revenue Cycle services in accordance with the corporate missionu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eDeciphers insurance coverage and benefits to ensure accuracy of all revenue cycle activities for assigned programu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eUpdates the electronic health system to reflect accurate insurance status of members served, authorization status and follow-up notesu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eReviews daily census for all members served to determine Revenue cycle intervention appropriatenessu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eFunctions as the primary point of contact between assigned programs and corporate officeu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eMaintains and expands knowledge base of payer requirements for both contracted and non-contracted entitiesu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003ePrepare and submit request for authorization of services provided to our clients, including initial authorization, extension or subsequent authorization requestsu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eTrack status of authorization request and follows up with payer to ensure authorization is granted, paying close attention to authorization date spans and service codesu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eResolves any authorization discrepancies with payer u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eActively participate in problem identification and resolution and coordinate resolutions between appropriate parties. u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAccesses various website or secure portals to obtain client eligibility statusu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eCommunicate daily with program staff to secure client information and documentationu003cspanu003eu0026nbsp; u003c/spanu003eu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eReview clinical data, diagnosis and procedure codes for authorizing request u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eDevelop and maintain professional, service-oriented working relationships with members served, clinicians, social workers, management and external parties in a courteous and efficient manneru003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAnalyze data, perform multiple tasks and work independently as well as in a team environment u003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003ePrioritizes daily work and assesses workload situationsu003c/spanu003eu003c/pu003enu003cp style=u0022margin-left: 27.0pt;u0022u003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eplan, organizeu003c/spanu003eu003cspanu003e, prioritize, and execute multiple and continuing assignments with general instructions.u0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eDuties and responsibilities may be added, deleted and/or changed at the discretion of management.u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eSKILLSu003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eAbility to use Microsoft Office Suite; Including Word, Excel, PowerPoint, etc.u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003ePractical knowledge of computer applications for database and presentation, electronic health records, and web-based applications, internet and calendaring softwareu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eExcellent oral and written communication skillsu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cspanu003eu0026middot;u003cspanu003eu0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u003c/spanu003eu003c/spanu003eu003c/spanu003eu003cspanu003eType 40 WPMu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003ePHYSICAL DEMANDSu003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cspanu003eThe physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job. u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eThe employee is constantly required to sit and occasionally required to stand, walk, reach, twist, bend, pull and lift and carry items weighing 10 pounds or less as well as to do simple grasping. The position requires manual deviation, repetition and dexterity. Visual requirements include computers and books exposure.u003cspanu003eu0026nbsp; u003c/spanu003eu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eu003cspanu003eEOE AA M/F/V/Disabilityu003c/spanu003eu003c/strongu003eu003c/pu003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement:The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:false,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:4f54269c-3a81-e250-e075-3a1a05307eef,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2020-09-03T00:07:21.613Z},{JobBoardId:2fcbb6f4-e717-17cb-9327-3dd87a55b08d,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2020-09-03T00:07:21.613Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null});

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