Case Authorization Manager
- Schedule patients within 24 hours of their evaluation if they qualify for therapy. Make sure all requirements by the plan are submitted to the appropriate department.
- Email therapist and supervisor with updates to their caseloads.
- Schedule and track re-evaluations for patient’s who will have an expiring auth. Follow up with parents to ensure all requirements are received or in the process of being completed. Track this on the re-evaluation tracker daily.
- Communicate with Medicaid Authorization Coordinators about clients for whom re-evaluations were completed, but no Medicaid authorization has been obtained. Communicate with parents/responsible party when a client must be placed on hold due to lack of Medicaid authorization. Educate parents about issues during this process (process after initial evaluation, expiration of authorization, loss of Medicaid coverage, etc).
- If at the reevaluation there is no prescription, call physician offices to obtain verbal order if occupational or physical therapy will begin, and there is no written prescription on file.
- Complete Advanced Daily Schedule to ensure authorizations and re-authorizations are current. Contact parents when items needed for auth are missing or if the patient needs to be placed on hold.
- Complete Conversion Report monthly and update charts that need changes.
- Maintain, update or archive Raintree schedule for the following information:
- The Speech, Occupational and Physical Therapy schedules on Raintree scheduler for each employee/contractor therapist.
- The Therapist’s Absence, Schedule Changes and Discharge Notification Form daily (Yellow Sheet).
- Schedule for coverage when therapists are out of the office unexpectedly.
- Maintain and update Raintree Waiting List and remove patients after 3 months.
- Attend any scheduled meetings to discuss, and provide written report about, the progress of new clients scheduling, as well as scheduling issues or concerns. Maintain daily metric reports on display as described in Standard Work.
- Assist and complete monthly Medicaid verification for all site patients as described in the Standard Work.
- Follow standard work established by the Cole Pediatric Therapy. Alert your supervisor if the standard work needs to be reviewed.
- Team Player
- Strong customer advocate
- Ability to problem solve
- Responds quickly and well to problems
- Takes initiative
- Even tempered under pressure
- Accurate, Dependable, Friendly, Polite
- Organize & complete tasks efficiently
- Able to prioritize tasks/multitask
- Communicates effectively (verbal, written, email, telephone)
- Bilingual Spanish/English Required
- Microsoft Office – Expert Level
- Associates Degree or equivalent job experience
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