Authorization and Appeals Specialist

BioTAB Healthcare • St. Louis, MO

102d

About The Position

The Authorization/Appeal Specialist is responsible for filing appeals for all authorization denials on the Case Processing team and training and back up all the Authorization Coordinators on the Case Processing team.

Requirements

• High School Diploma or GED required
• MS Office experience, minimum of six months required
• Data entry skills, minimum of six months required
• Basic medical terminology, minimum of six months required
• Excellent telephone skills, minimum of six months required
• Verbal and written communication skills, required
• Able to work in a team environment, required
• Medical documentation review, minimum of six months required
• Previous prior authorization experience, minimum of six months required
• Advanced knowledge of Medicare, Medicaid and commercial health insurance, required
• Experience working in a healthcare setting, required
• Attention to detail, required
• Critical thinking skills, required

Responsibilities

• File appeals on all authorization that have been denied
• Start and follow up on the insurance authorization process
• Train and support Authorization Coordinators
• Create medical documents
• Update patient files with relevant information
• Communicate with insurance companies by fax, email and telephone
• Effective communication with patients, sales team and corporate staff regarding the status of the patient’s authorization
• Willing to support all members of the team
• Comply with all HIPAA and privacy regulations
• Adhere to laws and best practices in regards to dealing with patients and patient data
• Perform other job-related duties as assigned

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED
• Number of Employees: 51-100 employees