Authorization Specialist I

Albany Medical Center•Albany, NY

118d•$49,763 - $69,668

About The Position

The Patient Engagement Authorization Specialist I (IAS II) is responsible for financially securing ambulatory, ancillary, surgical, and procedural services. This includes obtaining referrals and authorizations, verifying insurance, and interpreting benefits to ensure insurance guidelines are followed. The role interacts with patients and stakeholders to support successful financial clearance and compliance with authorization and referral requirements. The position operates in a high-volume, fast-paced environment and requires empathetic, compassionate handling of patients’ complex scheduling needs. The specialist uses eligibility applications and authorization portals to verify insurance eligibility, interpret responses, and record relevant health insurance information for the service being rendered. The role also requires interpreting and applying contractual benefits and collecting patients’ financial obligations before services. The position may involve access to sensitive information, including HIPAA-protected health information. Access and use must be limited to the minimum necessary to perform assigned duties, and information must be protected from unauthorized access or modification in accordance with Albany Med Health System policies and applicable requirements.

Requirements

Associate degree.
CHAA certification, or ability to acquire it within two years of hire.
Proven customer service skills and ability to exceed expectations.
Demonstrated knowledge of payer authorization requirements.
Strong attention to detail.
Ability to multitask in a stressful, high-volume patient environment and meet tight timeframes.
Ability to learn in classroom settings and use available resources.
Ability to remain composed under pressure.
Ability to review information and draw appropriate conclusions.
Good judgment, resourcefulness, and problem-solving ability, including escalating issues as needed.
Team-minded work ethic.
Ability to interpret patients’ insurance benefits and apply contractual obligations.
Critical-thinking ability regarding issues with financially securing payment.
Ability to engage patients, providers, provider staff, and insurance company representatives by telephone.

Nice To Haves

Bachelor’s degree.
Three to five years of experience in a hospital, physician office, or call center environment.
Strong insurance knowledge related to complex scheduling needs and authorization management.

Responsibilities

Secure financial clearance for ambulatory, ancillary, surgical, and procedural services.
Obtain referrals and authorizations and ensure compliance with applicable guidelines.
Verify insurance eligibility and interpret insurance benefits and payer requirements.
Use eligibility applications and authorization portals to request and review eligibility information and record appropriate health insurance details.
Apply contractual benefits and obligations to the service being rendered.
Collect patient financial obligations before services.
Interact with patients, providers, provider staff, and insurance representatives to support financial clearance and a positive patient experience.
Manage complex scheduling needs in an empathetic and compassionate manner.
Review information, draw appropriate conclusions, problem-solve, and escalate issues as needed.
Train and onboard colleagues.
Protect sensitive patient and organizational information by limiting access and use to the minimum necessary.