* Authorization Specialist * ($1,000 Sign On Bonus!)

Overview

This position verifies insurance coverage, benefits and obtains prior authorization for services. $1,000 sign-on bonus available (terms apply).

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.
• Maintains 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.
• Checks and responds to emails in a timely and professional manner.
• Performs all other assigned duties.

Qualifications

• Education: High School diploma or equivalent
• Prior Experience: Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience required; experience preferred.
• Skills and Proficiencies: Active knowledge of CMS guidelines, contracted insurance guidelines and coding policies; demonstrated computer literacy; well-organized with attention to detail; excellent math skills; critical thinking skills are strongly preferred; ability to establish and maintain effective working relationships; professional customer service skills; desire and dedication to work with self-discipline; maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Physical Abilities

• Ability to sit for long periods.
• Work requires walking, bending, standing, sitting, and reaching.