RCM Supervisor- Authorizations

Primary liaison with the state, Medicare, MCO’s, and private insurance plans regarding authorization and eligibility review issues for the organization.

· Ensure that all Provider and site-level credentialing are up to date.

Partner with employees regarding needed documentation.

· Responsible for obtaining proper credentialing with Medicare, Illinois Department of Healthcare and Family Services (HFS), MCOs, and private insurances

· Coordinate and educate employees regarding services provided and necessary steps to successfully obtain authorizations.

Partner with clinicians to ensure documentation is timely and supports the services identified.

· Submit and obtain updates regarding authorizations for service.

Communicate with employee’s pertinent information about the clients or their authorizations

· Review authorizations reports; and identify trends, issues, or barriers regarding obtaining authorizations to leadership

· Communicate to employees when a client’s insurance has lapsed.

Collaborate with new insurance to obtain authorization information.

· Collaborate with PHC Team/Group to ensure that all clients update their information in a timely manner for continued Medicaid Benefits.

· Respond to all benefit questions and provide Eligibility Results to Clinical Staff as requested.

· Perform other related duties and/or projects as assigned

 

Behaviors

Preferred


* Leader: Inspires teammates to follow them


* Enthusiastic: Shows intense and eager enjoyment and interest


* Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

See job description