Job Description
Absolute Authorizations LLC is looking to hire an experienced healthcare clinician for our Clinical Case Manager & Authorization Coordinator position. This is a fully remote position advocating patient care in Skilled Nursing Facilities.
Mandatory Experience:
- Experience working with Skilled Nursing Facilities
- Working knowledge reading clinical notes
- Obtaining Authorizations for Skilled Nursing Facility care
Responsibilities:
1. Submit detailed concurrent reviews and appeals highlighting Medical Necessity
2. Procure and maintain accurate tracking of all authorization and payer details
3. Identify and obtain reimbursement opportunities
4. Routinely correspond all outstanding billing details with Facility
5. Provide temporary case management coverage as needed
6. Coordinate and streamline communication between Insurance Case Managers and Facility clinicians
7. Serve as the primary point of contact and support for Facility staff addressing issues, questions, or concerns regarding their Managed Care population.
Qualifications:
1. Knowledge of SNF Medicare and SNF Managed Care guidelines
2. Knowledge of SNF Managed Care policies, procedures and processes.
3. Experience in a Skilled Nursing Facility setting (Rehab, Nursing, etc.)
4. Valid medical license and clinical experience
5. Excellent verbal and written communication skills
6. Organizational skills
7. Knowledgeable in Microsoft Suite and computer skills
