Authorization Specialist
Job Summary
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.
Essential Duties and 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.
- Maintain detailed and accurate records of all authorizations, including documentation of communications and follow-up activities.
- Communicate with patients regarding the status of their authorizations and provide assistance with any authorization-related questions or concerns.
- 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.
- Absent from the office - Visit local Medicaid offices to support the organization and assist patients with enrollment, eligibility, and related documentation.
Qualifications and Skills
- High school diploma or equivalent required; associate's or bachelor's degree preferred.
- Minimum of 1-2 years of experience in a healthcare-related role, with specific experience in authorizations preferred.
- 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.
- Knowledge of medical terminology, insurance terminology, and billing processes preferred.
- Ability to maintain confidentiality and handle sensitive information with discretion.
On-site
- Medical Insurance
- PTO & Sick Time
- Referral Program
Pay Range
The hiring range for this position is $29.00-$31.00/hour. Various factors will determine final compensation such as a candidate’s years of relevant work experience, skills, certifications, and location.
Benefits
- Patient Eligibility Review
- Coordination with Internal Teams
- Eligibility and Authorization Matters
Schedule
Full Time
Benefits
- Medical Insurance
- PTO & Sick Time
- Referral Program
Pay
The hiring range for this position is $29.00-$31.00/hour. Various factors will determine final compensation such as a candidate’s years of relevant work experience, skills, certifications, and location.