Authorization Specialist-Resp. Therapy

JOB SUMMARY

Performs all pre-authorization and authorization tasks required for treatment of patients in the Respiratory Therapy departments at Rivers Health. Enters all authorization data into EMR, sends all needed documentation to insurance companies as indicated. Provides front desk coverage for Respiratory Therapy as well. Contacts insurance companies for prior authorizations and benefit coverage for all Respiratory, Pulmonary, Cardiac, Sleep, and EKG services.

• Knowledge of Respiratory Therapy specific CPT and ICD-10 codes.
• Completes subsequent re-authorizations as needed.
• Verifies and documents insurance coverage for all services and procedures for prior authorizations and subsequent authorizations as needed.
• Schedule and receive patients for all services related to and within the Respiratory Therapy Department.
• Register all patients, contact insurances for prior authorization, and re-authorization.
• Prepare and maintain patient charts, specifically authorization documentation.
• Absorb and maintain tidiness of office and waiting area. Clean desk/countertops, cabinets, etc. as needed.
• Complete all required forms for authorization and registration processes.
• Answer the phone in an appropriate and courteous manner.
• Demonstrate excellence in customer service skills.
• Foster an atmosphere of teamwork and collaboration.
• Participate in staff meetings, in-services, and projects.
• Contact physician office for written order and other documentation as warranted.
• Absorb and assist in other department areas as needed on occasional basis as assigned by Manager or Director.
• Perform other related duties as assigned by Manager or Director.