Founded 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 we 're growing all the time! When you work at Telecare, you help to empower thousands of individuals every day in their journeys of recovery.
Telecare is proud to have been recognized by The Bay Area Business Times as the 9th Best Place To Work In the Bay Area for 2020! This is the 18th time we have made the list!
Our Corporate Headquarters has over 250 employees in following departments: Executive, Development, Finance, Information Systems, Human Resources, Operations, and Marketing & Operations.
Employment Status: Full-Time
Shift: Days, 8:30 am – 5:00 pm
Days: Monday - Friday
The 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. Position is the liaison between the programs and the Corporate Revenue Cycle Department.
· High School Graduation or G.E.D.
· Five (5) years professional experience in a healthcare facility
· Type 40 WPM or more
· Ability to read, write, and speak English
· Strong analytical and time management skills and attention to detail
· Ability to understand complex reimbursement structures and governmental regulations
· Ability to work and communicate effectively with customers, government representatives, management and staff
· Professional knowledge of Medicare, Medi-Cal/Medicaid, Managed Medicaid, managed care health plans and commercial insurance plans
· Knowledge of CPT and HCPCS codes and medical terminology
· Must be at least 18 years of age
· Must 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
· All 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 apply
· Two (2) or more years of college
· Experience in behavioral health organization
· Demonstrate the Telecare mission, purpose, values and beliefs in everyday language and contact with the internal and external stakeholders
· Assists in developing the overall philosophy and objectives of the Revenue Cycle services in accordance with the corporate mission
· Deciphers insurance coverage and benefits to ensure accuracy of all revenue cycle activities for assigned program
· Updates the electronic health system to reflect accurate insurance status of members served, authorization status and follow-up notes
· Reviews daily census for all members served to determine Revenue cycle intervention appropriateness
· Functions as the primary point of contact between assigned programs and corporate office
· Maintains and expands knowledge base of payer requirements for both contracted and non-contracted entities
· Prepare and submit request for authorization of services provided to our clients, including initial authorization, extension or subsequent authorization requests
· Track status of authorization request and follows up with payer to ensure authorization is granted, paying close attention to authorization date spans and service codes
· Resolves any authorization discrepancies with payer
· Actively participate in problem identification and resolution and coordinate resolutions between appropriate parties.
· Accesses various website or secure portals to obtain client eligibility status
· Communicate daily with program staff to secure client information and documentation
· Review clinical data, diagnosis and procedure codes for authorizing request
· Develop and maintain professional, service-oriented working relationships with members served, clinicians, social workers, management and external parties in a courteous and efficient manner
· Analyze data, perform multiple tasks and work independently as well as in a team environment
· Prioritizes daily work and assesses workload situations
· plan, organize, prioritize, and execute multiple and continuing assignments with general instructions.
Duties and responsibilities may be added, deleted and/or changed at the discretion of management.
· Ability to use Microsoft Office Suite; Including Word, Excel, PowerPoint, etc.
· Practical knowledge of computer applications for database and presentation, electronic health records, and web-based applications, internet and calendaring software
· Excellent oral and written communication skills
· Type 40 WPM
The physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
The 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.
EOE AA M/F/V/Disability
Equal Opportunity Employer Description
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
Pay Transparency Policy Statement
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)
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.