Supervises the daily operations of the eligibility and authorization (E&A) functions for Aveanna Healthcare. Functions under the responsibility of eligibility and authorization include obtaining patient benefits and authorization from the appropriate payers in a timely, compliant, and accurate manner. The Eligibility & Authorization Supervisor reports to the Eligibility & Authorization Manager.

Position Overview

The Eligibility & Authorization Supervisor will be responsible for the oversight of the E/A team of specialist(s). Aveanna is a rapidly growing home health and hospice organization with continued growth throughout the national market which requires ongoing prior authorization approval from Insurance companies prior to us providing services for our clients.

We are looking for an experienced Eligibility and Prior Authorization Supervisor that has worked in a preferably Home Health or Medical Healthcare environment. The ideal candidate will have knowledge of medical billing, payer prior auth requirements and processes and is able to thrive in a fast-paced environment to ensure the prior auth submission and follow up cycle times are within company expectations are critical objectives.

Essential Job Functions
Establish best practice protocols on obtaining timely prior auth approvals from multiple insurance companies and payers.
Provide direction and leadership for a team of prior auth specialists, assigning work as necessary to ensure timely completion of assignments per schedules and department criteria.
Create a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance; encourage and support employee decision-making within his or her scope of responsibilities.
Trains and mentors new prior auth specialists to company standards and processes.
Reviews and audits prior auth specialists work submission materials and their responses to payer decisions regarding coverage criteria ensuring accuracy and timely follow up.
Establish an internal tracking and monitoring system of submitted and approved payer prior auth requests and responses.
Monitoring payer response times and problem-solving related delays and issues.
Collaborate with cross departmental clinical and care teams through the prior auth process regarding inquires related to a payer's prior auth process or inquires and status updates with submitted requests.
Collaborate with internal RCM and billing departments to ensure we're meeting payer requirements and assist in the quality assurance review process.
Provide monthly reports on current volume, status, and outcomes of both completed and outstanding prior approval requests.
Provide ongoing communication to cross functional teams regarding payer prior auth requirements and payer behaviors.
Complete annual performance reviews for employees and provide timely feedback to employees and address performance/quality and training issues as appropriate.
Deliver positive patient experience.
Liaise appropriately with peers across the system; work with A/R department to communicate trends and suggest process improvements.
Complete disciplinary action as required.
Adhere to Aveanna organizational policies and procedures for relevant location and job scope.
Perform any special assignments as requested.
Requirements
Bachelor’s degree from a recognized college or university OR
At least five (5) years of related Revenue Cycle experience.
Clear understanding of the impact eligibility and authorization has on Revenue Cycle operations and financial performance.
Knowledge of government and non-government third party benefit and coverage rules.
Ability to craft, communicate, and align teams to the established departmental and corporate vision, by utilizing the capacity to simultaneously balance both the big picture strategic perspective and attention to detail.
Act as an enthusiastic coach and leader with demonstrated ability to recruit, mentor, train and develop employees, and monitor performance.
A demonstrated ability to use PC based office productivity tools (e.g. Microsoft Outlook, Microsoft Excel) as necessary and PC based financial tools (spreadsheets, data bases, financial planning software and graphics, Microsoft preferred) effectively for analyses and presentations; general computer skills necessary to work effectively in an office environment.

Preferences
At least five (5) years of related Revenue Cycle Billing experience.
At least three (3) years of supervisory experience preferred.

Other Skills/Abilities
Must always be able to adhere to confidentiality standards and professional boundaries
Attention to detail
Time Management
Ability to remain calm and professional in stressful situations
Strong commitment to excellence
Quick-thinking and astute decision-making skills
Effective problem-solving and conflict resolution
Excellent organization and communication skills

Physical Requirements
Must be able to speak, write, read, and understand English
Occasional lifting, carrying, pushing, and pulling of 25 pounds
Prolonged walking, sitting, standing, bending, kneeling, reaching, twisting
Must be able to sit and climb stairs
Must have visual and hearing acuity
Must have strong sense of smell and touch

Environment
Performs duties in an office environment during agency operating hours
Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna.