Authorization Specialist I

About the role

The Patient Engagement Authorization Specialist I (IAS II) is responsible for financially securing Ambulatory, Ancillary, Surgical and Procedural services. This includes securing Referral and Authorization. Insurance Verification and Benefit interpretation to discern insurance guidelines are being adhered to. Ability to interact with patients and stakeholders for the successful financial clearance will be critical to be successful in the compliance of authorization and referral guidelines.

Responsibilities

• Financially secure Ambulatory, Ancillary, Surgical and Procedural services.
• Secure Referral and Authorization.
• Verify and interpret insurance benefits to ensure adherence to guidelines.
• Interact with patients and stakeholders to facilitate financial clearance.
• Work in a high-volume, fast-paced environment.
• Manage complex scheduling needs with empathy and compassion.
• Use eligibility application and authorization portals to verify insurance eligibility and capture appropriate health insurance information.
• Apply contractual benefits to services rendered and collect patient financial obligations before services.

Requirements

• Associates Degree; Bachelor Degree preferred.
• CHAA (or acquired within 2 years of hire).
• Experience: 3 – 5 years’ experience in Hospital or Physician office experience or call center environment, preferred.
• Strong insurance knowledge specific to complex scheduling needs and authorization management.

Skills, Knowledge & Abilities

• Proven customer service skills with the ability to exceed expectations.
• Demonstrated knowledge of payer authorization requirements.
• Strong attention to detail.
• Ability to multi-task in stressful and high patient volume unit.
• Ability to manage pressure of very tight timeframes to execute tasks.
• Learn in classroom, utilizing resources.
• Remain composed under pressure.
• Train and onboard colleagues.
• Review information and draw appropriate conclusions.
• Good judgment and ability to problem solve; escalate issues as needed.
• Team-minded work ethic.
• Demonstrate ability to interpret patient’s insurance benefits and apply applicable contractual obligations.
• Critical thinking ability regarding issues with financially securing payment.