Authorization Specialist

About the role

Authorization Specialists are responsible for providing exceptional customer service, collecting insurance information, ensuring correct benefits, and securing authorizations to help our families maintain coverage for services.

Responsibilities

• Confirm insurance coverage
• Determine necessity for pre-authorization and obtain authorization for scheduled patients
• Help perform eligibility checks for ongoing patients
• Provide standardized documentation within system to identify prior authorization and the criteria surrounding such authorization accurately and timely
• Notify patients and/or clinical staff of any services requested and/or referred that are not authorized by insurance
• Contact physician offices via fax and/or phone to obtain information necessary to secure an authorization
• Contact insurance offices via fax, portals, and/or phone to obtain authorization
• Monitor all tasks using workflow software and meet the deadlines associated with tasks
• Advise clinical staff when issues arise relating to obtaining prior authorization
• Adhere to policies and procedures of Hopebridge
• Assist with problem solving to improve efficiency and morale within the office
• Portray a positive attitude and maintain a customer and co-worker satisfaction level that limits adverse situations or complaints
• Promote Hopebridge philosophies, generating team spirit and creating and maintaining an environment that fosters staff satisfaction, maximizes productivity and profitability
• Attend weekly meetings and training as requested
• Other duties as assigned

Qualifications

• Must be at least 18 years of age
• Possess a minimum of a high school diploma

Preferred Qualifications

• Healthcare experience preferred but not necessary
• Healthcare terminology preferred
• Salesforce experience preferred

Required Skills

• Proficient computer skills
• Strong attention to detail
• Collaborative attitude with others
• Ability to identify and solve problems
• Mission-driven commitment to the job
• First-class customer service skills
• Self-driven time management skills
• Ability to handle stress in fast-paced environment
• Ability to multi-task and support multiple priorities

Schedule

Flexibility in hours is allowed, but the employee must be available during the "core" work hours of 7:00 a.m. to 5:00 p.m.

Work environment

Work is performed in an office environment. Work may be stressful at times due to a busy office. Interaction with others is constant and interruptive.

Physical demands

This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. Employees in this position must be physically able to efficiently perform the essential functions of the position.