Authorization Specialist

American Vision Partners • Salinas, CA

2d • Onsite

About The Position

This position verifies insurance coverage, benefits and obtains 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 experience preferred.
• 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
• Critical thinking skills are strongly preferred
• 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.
• Ability to sit for long periods. Work requires walking, bending, standing, sitting, and reaching

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.

Benefits

• medical and dental insurance
• significant eye care discounts
• child care assistance
• pet insurance
• continuing education funds
• 401(k)
• paid holidays
• PTO
• Sick Time
• opportunity for growth

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED