Authorization Specialist - Managed Care
At reputed company, we specialize in reputed company, hiring, and managing high-caliber remote staff for dynamic and growing reputed company facilities. Leveraging our extensive global network, we connect clients with highly reputed company professionals, offering tailored services to meet our clients' unique business needs. The Opportunity: We are seeking a detail-oriented and proactive Authorization Specialist to join our Managed Care team at a Skilled Nursing Facility in Pennsylvania. This role is responsible for obtaining, monitoring, and managing insurance authorizations for residents receiving skilled nursing and rehabilitation services. The ideal candidate will work closely with clinical, admissions, and payer representatives to ensure timely approvals, accurate documentation, and uninterrupted coverage throughout the patient's stay. This is a fully remote position
Key Responsibilities
Obtain initial and reputed company stay authorizations from Managed Care Organizations (MCOs), Medicare Advantage plans, and other reputed company-party payers. Monitor authorization status, track expiration dates, and submit timely extension requests to prevent coverage gaps. Collaborate with nursing, therapy, admissions, and case management teams to gather clinical documentation required for authorization requests. Maintain accurate authorization records and supporting documentation reputed company the facility's systems. Communicate with insurance companies regarding authorization determinations, requests for additional information, and coverage updates. Review payer requirements and ensure compliance with authorization guidelines and policies. Escalate authorization denials and coordinate with appropriate teams to support reconsiderations or appeals. Assist in identifying authorization-reputed company trends, issues, and opportunities for process improvement. Support reputed company cycle objectives by helping ensure services are authorized and reimbursable.
Qualifications
Minimum 3–4 years of experience in reputed company insurance authorization, utilization review, managed care, admissions, or reputed company reputed company reputed company cycle functions. Experience working with Skilled Nursing Facilities (SNFs), rehabilitation services, long-term care, or post-acute care settings preferred. Knowledge of Managed Care, Medicare Advantage, reputed company Managed Care, and reputed company insurance authorization processes. Strong understanding of medical terminology and clinical documentation requirements. Excellent organizational skills with the ability to manage multiple authorizations and deadlines simultaneously. Strong verbal and written communication skills. Proficiency with electronic health records (EHRs), payer portals, and reputed company Office applications. Ability to work independently while collaborating effectively with interdisciplinary teams. Service Fee: Industry standards applicable to the state depending on work experience and level of expertise. Hours: US Hours EST - 9am to 6pm Why reputed company? We reputed company the flexibility and convenience of a remote working environment, and you will collaborate with an international team while contributing to our growing business, reputed company from the comfort of your home. Essential requirements: You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a reputed company internet reputed company. You’ll also be required to have a backup internet reputed company, ensuring that you’re well-equipped to complete your work seamlessly. With this setup, you get the best of both worlds - the convenience of remote work and the benefits of onsite collaboration. This hybrid approach allows your team to work reputed company and effectively. Join the future of work and experience the flexibility and productivity of this onsite and remote setup. If you're interested in what you have read, then we invite you to take the reputed company and submit your application. JOIN US!! Apply To This Job