Senior Authorizations Associate

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $70k - $88k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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Habitat Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2023

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Habitat Health is a healthcare organization focused on empowering older adults to live independently in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), Habitat Health provides comprehensive health insurance coverage and medical and social care services. Their services include transportation, personal care, 24/7 care access, physical therapy, nutrition support, pharmacy and prescriptions, medical care, and social services. Operating in partnership with notable healthcare providers such as Kaiser Permanente, Habitat Health is committed to creating a supportive and inclusive environment for both participants and staff, ensuring the provision of personalized, coordinated care. Founded in 2023, the company aims to enhance the lives of older adults covered by Medicare or Medicaid.

📋 Description

• Own the end-to-end authorization workflow from validating new referrals through finalization, post-service authorizations, and follow-up • Process referrals and authorizations across all systems of record within strict regulatory timeframes • Track authorization timelines, expirations, and extensions • Review and validate referrals for participant, provider, reason, clinical approval, and network details before handoff to scheduling • Manage compliant follow-up and close-out of referrals, including confirming follow-up from after-visit summaries • Route requests requiring clinical review to appropriate PCP or IDT members and track them to a decision • Partner with Patient Access, Medical Records, Network Management, Claims, and local care teams to resolve authorization discrepancies • Facilitate single case agreements end-to-end with the Network team • Maintain accurate referral and authorization statuses as enrollment changes • Document actions, contacts, and outcomes in the EHR and authorization systems while following standardized workflows and HIPAA requirements

🎯 Requirements

• Associate’s degree (or equivalent combination of education and experience) and 2+ years of experience in prior authorization, referral coordination, or healthcare administration required • Bachelor’s degree in healthcare administration or a related field preferred • Working knowledge of medical terminology, health insurance benefits, and authorization processes • Medicare/Medicaid managed care experience strongly preferred • Experience with single case agreements, out-of-network authorizations, or retro-authorizations preferred • Familiarity with Kaiser Permanente referral processes is a plus • Experience with electronic health records (e.g., Epic), payer portals, and authorization management systems • Proficiency in Microsoft Office • Strong attention to detail, organization, and time management, with the ability to manage multiple deadlines and own turnaround times • Ability to adapt to changes and learn new systems quickly • Excellent verbal and written communication skills • Strong passion for the mission, with a high degree of empathy for the populations served • Authorization to work in the United States verified through E-Verify • Compliance with applicable infection control protocols, PPE requirements, and vaccination requirements associated with the role and work location

🏖️ Benefits

• Health insurance • Life insurance • Participation in the company’s equity program • Paid time off, including vacation and sick leave • Reasonable accommodations for disabilities and sincerely held religious beliefs • Vaccination and infection control accommodations where applicable

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