Authorization Specialist

Western Missouri Medical Center•Warrensburg, MO

3d•Onsite

About The Position

The Authorization Specialist at Western Missouri Medical Center is responsible for verifying insurance benefits, validating authorization requirements, and obtaining necessary authorizations for services ordered or performed within the center and its clinics. This role involves direct interaction with payers to ensure proper authorization is secured for patient services, and requires diligent follow-up on any denials related to authorization issues. The position also encompasses pre-registration duties, collecting accurate patient demographic and insurance information, determining patient financial responsibilities such as co-pays and deductibles, and accurately entering Medicare MSP information. The specialist must demonstrate competency in using equipment and supplies, maintain professionalism, work independently to meet deadlines, and make informed decisions. A positive attitude, teamwork, collaboration with internal customers and providers, adherence to policies and procedures, willingness to take on additional assignments, and consistent attendance are also key aspects of this role.

Requirements

High school diploma or equivalent.
Typing skills of 45+ WPM.
Previous clerical experience.
Great customer services skills.
Previous medical support services experience.
Must be self-motivated and have the ability to work within the established policies, procedures and practices prescribed by the hospital/clinic.

Responsibilities

Verify insurance benefits for the patient.
Work directly with payer to validate and obtain authorization for services on behalf of the patient.
Follow up on denials related to authorization issues.
Perform pre-registration duties as requested.
Obtain correct patient demographic and insurance information.
Determine patient’s financial responsibility (i.e. co-pays and deductibles).
Collect and enters accurate MSP information for Medicare patients.
Demonstrate competency with equipment, utilizes supplies and equipment properly.
Demonstrate behaviors which promote professionalism.
Work without constant supervision, meets deadlines, makes decision based on relevant facts.
Maintain a positive attitude and behaviors in keeping with the Medical Centers Mission, Vision and Value Statement of Behavior.
Promote and instills the teamwork concept by assisting co-workers when appropriate.
Collaborate with other internal customers, providers, as appropriate, to accomplish the work of the department.
Consistently follow established Departmental, Human Resources and Hospital Policies and Procedures.
Demonstrate willingness to accept additional assignments.
Maintain regular and predictable attendance.
Perform other essential duties as assigned.