Authorization Specialist

American Vision Partners•Phoenix, AZ

22h•Onsite

About The Position

American Vision Partners (AVP) partners with leading ophthalmology practices to provide high-quality patient care through best-in-class management systems, operational infrastructure, and advanced technology. AVP operates over 100 eye care centers across Arizona, New Mexico, Nevada, California, and Texas, including 25 ambulatory surgical centers. The company values teamwork, exceptional experiences, continuous improvement, financial strength, and hard work, and is committed to patient care, pioneering research, and employee recognition. This Authorization Specialist position is responsible for verifying insurance coverage and benefits, and obtaining prior authorization for services.

Requirements

High School diploma or equivalent
Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience required
Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
Demonstrated computer literacy
Well-organized with attention to detail
Ability to read and understand oral and written instructions
Excellent math skills
Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
Professional customer service skills.
Have a desire and dedication to work with self-discipline.
Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Nice To Haves

experience preferred
Critical thinking skills are strongly preferred

Responsibilities

Contacts insurance plans to determine eligibility and obtain coverage and benefit information.
Obtains prior authorization for services.
Processes requests for prior authorization for surgery and/or procedure injections.
Identifies and resolves problems with participant eligibility/insurance coverage.
Accurately calculates patient responsibility amounts based on benefit information and payer allowable.
Documents findings thoroughly and accurately.
Prioritizes work to maximize turn-around time.
Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
Maintain an error rate in accordance with departmental policy.
Makes changes to demographic information as necessary in order to produce a clean patient statement.
Answer and respond to external and internal phone calls in a timely manner.
Check and respond to emails in a timely and professional manner.
Performs all other assigned duties.
Conducts self in accordance with the company’s standard values and policies.
Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels.