Authorization Specialist

Baptist • Jackson, MS

20h

About The Position

Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership when dealing with patient preauthorization functions, including inpatient and outpatient services. Coordinates efforts between departments to ensure accurate precertification, resulting in timely billing of claims. Some overtime and call back may be required. Performs other duties as assigned.

Requirements

• Minimum 2 years of office and/or clinical experience.
• Knowledge of medical terminology
• Advanced communication, conflict management, organizational and planning skills; advanced computer literacy skills.

Nice To Haves

• Experience in a clinic setting as well as dealing with prior authorizations.
• Associates degree in related field
• LPN license

Responsibilities

• Precertifies patient care services that require precertification, in a timely, efficient manner, in order to optimize reimbursement for the patient as well as health care providers.
• Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.
• Reviews orders for accuracy and medical necessity to facilitate delivery of services and appropriate reimbursement.
• Addresses issues identified with retrospective reviews for all payers.
• All outpatient procedures will be timely precerted when applicable.
• Works to improve the QI/PI process.
• Assumes responsibility for personal growth and development by attendance and / or participation in inservices and continuing education programs.
• Completes assigned goals.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees