Authorization Specialist

Option Care Health•Sacramento, CA

3d•$23 - $33

About The Position

Submits accurate and timely authorization requests to ensure proper reimbursement for patient services. This role involves setting up patient accounts, obtaining necessary clinical documentation, and verifying medical necessity. The specialist must have a solid understanding of basic medical coding, diagnosis codes, and medical terminology. Strong attention to detail, organizational skills, and the ability to work collaboratively with healthcare providers and payers are essential for success in this role.

Requirements

High school diploma or equivalent is required.
Ability to multi-task and support numerous referrals/priorities at one time.
Ability to work in a fast past environment.
High degree of self-discipline in maintaining productivity expectations.
Must be detail-oriented and have a high degree of quality focus.

Nice To Haves

Healthcare/medical billing experience preferred.

Responsibilities

Submit accurate and timely authorization requests to insurance companies and payers
Ensure proper setup and maintenance of patient accounts in the system
Obtain and review clinical documentation to verify medical necessity
Communicate with healthcare providers to gather required information for authorizations
Verify insurance benefits and eligibility for services
Monitor the status of authorization requests and follow up as needed
Ensure compliance with payer requirements and regulations
Utilize basic medical coding, diagnosis codes, and medical terminology in the authorization process
Maintain detailed records and documentation for all authorizations
Collaborate with billing and claims teams to resolve any authorization-related issues