Insurance Authorization Specialist - Utilization Management

McLeod Health • Florence, SC

34d

About The Position

Insurance Authorization Specialist role is the secure third-party payer authorization for services rendered by completing accurate and timely authorization requests. They are also responsible for communicating authorization follow up and outcomes in the patient medical record.

Requirements

• One year of prior office experience in healthcare setting and/or related work experience.
• High School/Ged

Responsibilities

• Collaborates with clinical team to send appropriate supporting documentation as required by payor.
• Responsible for entering all required authorization information into appropriate system.
• Responsible for communicating exhaustion of benefits to staff as well as concurrent denial information.
• Maintains and expands awareness of preauthorization services for insurance coverage with all payors, investigating for potential coverage that may not have been provided, obtaining prior authorization for services to be performed and necessary documentation to ensure proper payment.
• Assist with denial workflow and communication with physician advisor team.
• Assist with fax line and voicemail.
• Performs all other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees