Authorization Specialist Jobs

About The Position

Requirements

• High School
• 1-2 years experience in healthcare insurance billing and verification, collections and/or authorizations.
• Knowledge of clinic policies and procedures.
• Knowledge of managed care contracts and utilization.
• Knowledge of computer systems, programs and spreadsheet applications.
• Knowledge of medical terminology.
• Knowledge of CPT/ICD-9
• Skill in gathering and reporting claim information.
• Skill in solving utilization problems.
• Skill in written and verbal communication and customer relations.

Responsibilities

• Obtaining required referrals and authorizations prior to services via phone, fax, on-line, etc.
• Review office schedules daily for patients requiring authorizations, referrals, pre-notification, and insurance eligibility verification.
• Obtaining retro-authorizations or updating existing authorizations in a timely manner.
• Inputting/updating authorization information into EHR.
• Updates the patient account with details of the insurance verification.
• Identifies deductibles, co-pays, and self-pay accounts. Identifies large dollar DME accounts.
• Notifying the appropriate staff members if treatment or service is denied.
• Coordinating with the Financial Counselor necessary information for patient discussions.
• Working with the provider if a peer-to-peer review is necessary or requested by the payer.
• Keeping up-to-date on third party payer authorization requirement information.
• Re-verify all patients monthly for active, current insurance.
• Assist Collection staff with account questions when presented.
• Participates in professional development efforts to ensure currency in health care practices and trends.
• Perform other duties as assigned.

Benefits

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!