Clerical Support and Authorization Specialist

Home & Health Care Management is the oldest home health care agency in Northern California. Our agency specializes in delivering comprehensive in-home care and case management for older adults, children, and those living with disabilities across many counties. We use a matrix of Medi-Cal, Medicare and targeted health programs to find solutions that work for our clients

The Role: The Clerical Support and Authorization Specialist provides clerical and insurance authorization support to a multi-disciplinary team of nurses and social workers through CCT, ALW and 811 programs, as well as the Intermittent team when appropriate.  This role ensures efficient coordination of services, timely and efficient processing and submission of initial and ongoing authorizations, as well as effective communication among staff, clients, and providers to support high-quality, person-centered care.

Responsibilities:

Insurance Authorizations & TAR Management

Prepare and submit Treatment Authorization Requests (TARs) for CCT/ALW/811 related home health visits.

Verify insurance eligibility and benefits prior to scheduled visits.

Track authorization status and follow up with payers to ensure timely approvals.

Maintain authorization logs and ensure approved units align with scheduled services.

Communicate authorization updates to clinical and field staff.

Obtain retro authorization when necessary.

Assist with resolving authorization-related claim denials.

Support billing team by ensuring authorizations are in place prior to claim submission.

Ensure all authorizations meet payer and regulatory guidelines.

Clerical & Administrative Support

Maintain Excel spreadsheets tracking participant lists, completed calls, and received documentation.

Process large volumes of paperwork received electronically and via U.S. Mail; upload all relevant information into clients’ medical records.

Prepare professional correspondence to clients/patients, physicians, and other healthcare providers.

Support quality assurance activities, including review and audit of medical records.

Take meeting notes and prepare accurate, well-organized minutes for team distribution.

Respond promptly to client and provider phone calls regarding CCT/ALW/811 inquiries.

Provide clerical support across all programs administrative functions; cross-trained in multiple support areas.

Perform other duties as assigned to ensure efficient program operations.

Back up to CCT/ALW/811 and Intermittent Clerical Support.

Send and maintain Orders to Physicians and POC’s.

Essential Requirements:

One year+ of work experience processing TAR’s and insurance Authorizations, as well as clerical support or data entry.

Strong organizational skills with attention to detail.

Ability to maintain confidentiality to HIPAA standards.

Ability to work with diverse populations.

Strong written and verbal communication skills.

Ability to follow through with projects with minimal assistance and supervision.

Ability to prioritize projects, work relatively independently, manage multiple tasks, and meet recurring deadlines.

Ability to cooperate and communicate effectively with clients, supervisors, and co-workers, creating a mutually beneficial working relationship.

Proficiency with Microsoft Office suite including Outlook, Word, and Excel.

Ability to work with others, at all levels within the organization, and collaborate effectively.

Critical thinking skills and willingness to learn new skills.

Valid California Driver’s License.

Eligible to be insured under our liability policy with a clean DMV report.

Have your own vehicle and proof of current auto insurance.

High School Diploma or GED equivalent.

Ability to communicate effectively and efficiently in English, both verbally and in writing.

Bilingual (Spanish, Russian) language is a plus.

Schedule:

This position is Full-time, 40 hours a week, Monday-Friday from 8am-5pm with 1 hour lunch, reporting to our Chico office. 

Travel:

Some travel is required such as, in-home visit, doctor office, training etc. to surrounding area of your home office, and all other HHCM offices.

Physical Requirements:

Conditional job offer is successfully passing a medical exam that tests amongst other things the ability to move, visual acuity, and hearing acuity. Physical requirement for this role specifically includes:

Sits, stands, bends, lifts, walks, and moves intermittently during working hours.

Able to lift to 35 pounds without assistance.

Compensation:

Starting pay is $23.00 - $25.00 Per hour

Benefits

You will be reimbursed for the mileage you travel from the office to participant’s homes.

You will receive a monthly phone stipend.

On the first of the month following 2 months of employment you will be eligible for health insurance, dental insurance, vision insurance, life insurance, long term disability insurance as well as Flexible Spending Account (FSA).

We offer 401(k) matching up to 4% after 1 year of employment and 1,000 hours worked.

Leave accrues starting on your first day of employment, and you can take paid vacation, sick and holiday leave after 90 days.

You will be reimbursed for any mileage you travel from the office.  

Apply

If you have an interest in joining our amazing team, we would like to hear from you!

Click here to apply online.

You can also download the application packet located at www.homeandhealthcaremgmt.com and fax completed applications to 530-487-8585 or mail to us at 1398 Ridgewood Dr., Chico, CA 95973, Attention: HR Department.