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Insurance Authorization Nurse Opening

WILLCARE, a successful regional leader in the home health care industry, currently has a job opening for an Insurance Authorization Nurse in our Corporate Office In Buffalo, NY.  In business for over 25 years, WILLCARE operates Certified/Medicare, Long Term Care, Licensed/Private Duty, as well as non-medical services and supplemental staffing agencies. We provide qualified skilled and non-skilled services focusing on preventative, rehabilitative and therapeutic care to our clients in all applicable settings. We have branch offices in Western NY, Hudson Valley NY, Connecticut, and Ohio.

Job Title:  Insurance Authorization Nurse 
Job Locations:  Buffalo NY
Job Department:  Insurance Authorization
Status:  Full-Time 

INSURANCE AUTHORIZATION NURSE JOB SUMMARY

Responsible for administering timely and accurate insurance authorization approvals.

INSURANCE AUTHORIZATION NURSE ESSENTIAL DUTIES & RESPONSIBILITIES

• Secures authorizations for all managed care cases in a timely & thorough manner to maximize timely billing and prevent bad debt.
• Tracks all authorizations and maintains data base of authorization information, as well as status/outcome of all requests.
• Provides management with ongoing reports on trends in offices regarding following authorization protocols.
• Communicates timely with clinical staff and third party payers regarding medical necessity for authorizations for home care services and reminders regarding insurance authorization expirations.
• Maintains data in computer system(s) and verifies the accuracy of the information.
• Communicates with scheduling coordinators, clinical staff and managers / supervisors regarding inquiries/referrals.
• Develops policies and procedures in order to operate an efficient Authorization’s Department.
• Conducts training sessions for clinical and office staff regarding authorization policies and procedures, and necessary documentation.
• Works closely with billing and accounting staff to facilitate timely and accurate billing, and prevent denials and bad debt.
• Duplicates and collate forms, reports, correspondence, etc. as required.

EDUCATION & QUALIFICATION REQUIREMENTS

• Bachelor’s Degree in Nursing or related health care field.
• Three (3) years nursing experience and 2 years office / supervisory experience or an equivalent of both.
• Computer proficiency.

For additional details, see: 

JOB DESCRIPTION (click to open PDF file)