Authorization Specialist

Elite Home Health Care•New York, NY

6d•$29 - $31•Onsite

About The Position

The Authorizations Specialist plays a critical role in obtaining and managing authorizations for medical services provided to patients. This individual will be responsible for entering authorizations into the system, following up on missing authorizations, and ensuring that all necessary authorizations are obtained before billing. The Authorizations Specialist will work closely with patients, healthcare providers, and insurance companies to facilitate the authorization process efficiently and accurately.

Requirements

High school diploma or equivalent required
Minimum of 1-2 years of experience in a healthcare-related role
Strong organizational skills and attention to detail, with the ability to manage multiple tasks and priorities simultaneously.
Excellent communication skills, both written and verbal, with the ability to interact professionally with patients, healthcare providers, and insurance company representatives.
Proficiency in using computer systems and software applications, including electronic medical records (EMR) systems and Microsoft Office Suite.
Ability to work independently with minimal supervision and make sound judgments based on established guidelines and procedures.
Ability to maintain confidentiality and handle sensitive information with discretion.

Nice To Haves

associate's or bachelor's degree preferred
specific experience in authorizations preferred
Knowledge of medical terminology, insurance terminology, and billing processes preferred.

Responsibilities

Enter authorizations for medical services into the appropriate systems or databases accurately and promptly.
Follow up on missing authorizations by contacting patients, insurance companies, and healthcare providers to obtain the necessary documentation.
Monitor the status of authorizations and follow up with insurance companies and healthcare providers as needed to expedite the approval process.
Coordinate with the billing department to ensure that all authorized services are billed accurately and in a timely manner.
Communicate with patients regarding the status of their authorizations and provide assistance with any authorization-related questions or concerns.
Maintain detailed and accurate records of all authorizations, including documentation of communications and follow-up activities.
Collaborate with other members of the healthcare team, including physicians, nurses, and administrative staff, to ensure that all authorization requirements are met.
Stay informed about changes to insurance regulations, policies, and procedures related to authorizations and ensure compliance with relevant guidelines.
Prepare accurate reports related to patient authorizations and insurance eligibility.
Review patient eligibility and coordinate follow-up with patients, payers, and internal staff to resolve coverage issues.
Assist disenrolled patients with the Medicaid re-enrollment process to restore eligibility and maintain access to services.
Collaborate with internal teams and external agencies to ensure timely resolution of eligibility and authorization matters.
When needed, visit local Medicaid offices to support the organization and assist patients with enrollment, eligibility, and related documentation.
Perform other duties as assigned.