*GENERAL DEFINITION OF WORK: FLSA Status: Non-Exempt*
Processes authorization request for Developmental Disability (DD) Waiver services providers utilizing the Waiver Management System (WaMS).
Uploading required documents into WaMS.
Communicate with providers, DBHDS, DMAS, throughout the authorization process to resolve any authorization issues.
Track the authorizations throughout all stages.
*ESSENTIAL FUNCTIONS:*
Tracks all plan and authorization deadlines.
Initiates authorization requests for all authorization that must be completed by waiver providers.
Follows the progress of all authorizations until final approval by Department of Medical Assistance Services (DMAS).
Troubleshoots authorizations that were pended, rejected, or otherwise stalled, by communicating with necessary parties to resolve.
Monitors transmission of documents from credible to WaMS by reviewing authorization response reports and communicates with SC when transmission errors need to be resolved.
Upload required documents to WaMS, such as Annual Risk Assessment tools, Onsite Visit Tools.
Manage waitlist (WL) activities in WaMS (add people to WL, get updated diagnostic documentation).
Make updates in WaMS when client information changes.
Working with teams on transfer of waivers in WaMS (CCC plus to DD and transfer of DD waiver types).
KNOWLEDGE, SKILLS AND ABILITIES:
Ability to use specialized authorization platform (WaMS) and electronic health record system.
Ability to track and meet large number of deadlines and staggered deadlines.
Ability to communicate with people receiving services, family members, representatives from regulatory agencies, and other internal and external stakeholders.
*EDUCATION AND EXPERIENCE:*
Associates degree preferred.
*PHYSICAL REQUIREMENTS:*
This work requires little or no physical effort or exertion.
Majority of time spent using a computer / laptop; cell phone
Some mental effort and stress involved resulting in inconvenience and frustration
May be primarily telework; occasional in person meeting requirements
*SPECIAL REQUIREMENTS:*
Valid Virginia driver’s license; attends training and maintains certifications as required by the Agency and regulatory guidelines.
Encompass Community Supports does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, or military service.
Job Type: Full-time
Benefits:
* Dental insurance
* Health insurance
* Paid time off
* Retirement plan
* Vision insurance
Schedule:
* Monday to Friday
Education:
* Associate (Preferred)
Experience:
* Insurance verification: 1 year (Preferred)
* Medical billing: 1 year (Preferred)
Work Location: In person
Whatsapp
