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Authorization Associate (Org Wide) (Home-Based)

May 29, 2026

Description Join our award winning culture as we serve members in your area! This Authorization Associate role focuses on Self-Directed Supports authorization entry. Under the general supervision of the Service Utilization Supervisor, this position manages service authorizations in the Lakeland Care electronic member record system. This position supports Interdisciplinary Teams (IDT) by ensuring authorizations are accurately completed based on IDT Resources Allocation Decision (RAD) determinations, maintaining compliance with policy and documentation requirements. As a subject matter expert, this position reviews service guidelines, verifies provider information, monitors quality and compliance, coordinates with claims as needed, and provides resources to IDT staff on best practices to ensure accurate authorizations, documentation, and claims processing. Essential Competencies:<ul><li>Timely and accurately enter and modify service authorizations into the electronic member record system, thereby reducing risk for duplicate claims, missing claims, or incorrectly coded claims. Review service guidelines, coordinate with claims on payment accuracy, and ensure authorizations align with policy requirements.</li><li>Conduct routine authorization audits and remediate any findings to ensure accuracy of service authorizations and appropriate payment of claims.</li><li>Contribute to ongoing quality improvement within the service authorization entry process, including auditing and analysis.</li><li>Conduct quality reviews of required documentation and provider information (e.g., SNF HIPPS codes, TIN changes) to prevent delays in member services.</li><li>Respond constructively to emotional situations, high pressure, and conflict.</li><li>Demonstrate emotions appropriate to the situation and continue to perform steadily and effectively.</li><li>Convey messages concisely and advise others regarding an appropriate course of action.</li><li>Teamwork is essential at all times.</li><li>Identify obstacles and address problems cooperatively as they occur.</li><li>Utilize and apply relevant Standard Practice Codes (SPCs) to ensure appropriate and accurate claims processing.</li><li>Provide guidance and share resources to ensure consistent adherence to policies, correct coding practices, and best practice standards for designated services.</li><li>Review organizational data and analyze utilization trends to bring forward for Care Management practice review.</li></ul>Requirements<ul><li>Associate Degree or specialized training in Medical Records, Medical Coding, other related field preferred, or equivalent combination of education and experience (includes knowledge, skills, and abilities).</li><li>One (1) year of experience in medical billing or insurance authorization preferably in Family Care or health care setting. </li><li>Strong understanding of service authorization guidelines, policies and procedures.</li><li>A strong understanding of Lakeland Care’s electronic member records system is necessary to ensure that all authorizations are correctly entered.</li><li>Knowledge of medical terminology and/or experience with CPT, ICD-9 and ICD-10 coding.</li><li>Knowledge of Medicare, Medicaid, Family Care preferred.</li><li>Excellent verbal and written communication; ability to respectfully and effectively communicate with internal and external partners.</li><li>Attention to detail and the ability to critically think in a fast-paced environment.</li><li>Computer literate including experience with spreadsheets, MS Word, e-mail, and the internet.</li><li>Current driver’s license, acceptable driving record and proof of adequate insurance required. </li></ul>------------------------------------------------------------------------------------------------- Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 11 offices throughout the Central to North East region of Wisconsin. Our MissionEmpowering individuals. Strengthening communities. Inspiring futures. Our VisionTo create a world we all want to live in. Our Core ValuesKindness – We believe kindness is always possible and that no compassionate act is ever wasted.Inclusion – We believe that open hearts and open minds are the only path to a brighter future.Trust – We believe that honesty is still in style and that promises still have power. We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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