Authorizations Specialist

Description

The Authorization Specialist supports the Clinical, Imaging, and Physical Therapy departments. Daily tasks will include verification of a patient’s insurance information, obtaining authorizations for, but not limited to, procedures, surgeries, injections, imaging, office visits, and pre-collection for upcoming services to be rendered. This role will also actively interact with the medical staff and patients.

Essential Functions

• Authorize scheduled procedures to include surgeries, injections, medications, physical and occupational therapy, imaging and other items needing authorization with insurance.
• Verify eligibility and benefits for all patients and procedure codes, pre-collect payment for surgeries and other procedures as required by the department.
• Ensure compliance with benefits, authorizations, and/or funding requirements and limitations.
• Confirm that all information documented in the Practice Management System is accurate.
• Document work processes as required.
• Educate staff members on authorization obligations and accountability to internal processes in a timely manner.
• Manage authorization queue, workbook, or schedule by auditing daily changes and having clear documentation.
• Setup Patient tracking via tasking within the patient Electronic Medical Records System.
• Innovate processes to facilitate the most efficient workflow.
• Document in Electronic Health Records System prior authorizations information obtained.
• Treatments authorized, date range approved for, authorization numbers and insurance company contact information must be recognized and responded to appropriately.
• Follow all written protocols and procedures of the clinic including the OCC handbook, all department policy and procedures.
• Provide timely, high quality patient service and submission of authorizations, from all areas of responsibility by being courteous and helpful to all.
• Perform other duties assigned by OCC leadership.

Requirements

• MEDICAL TERMINOLOGY, ICD-10 AND CPT CODING KNOWLEDGE
• SOLID COMPUTER AND PHONE SKILLS
• STRONG ORGANIZATIONAL AND INTERPERSONAL SKILLS
• ABILITY TO PRIORITIZE RESPONSIBILITIES AND MULTI-TASK EFFICIENTLY AND EFFECTIVELY
• ADAPTABILITY TO DIFFERENT PLAN AND LIEN REQUIREMENTS

Pay & Benefits

• Medical, Dental and Vision Insurance
• Generous PTO package and paid holidays
• Company-paid life insurance and long term disability insurance
• Opportunities for internal training and development
• Retirement Plan eligibility after one month of service with eligibility in company profit sharing
• Most positions offer Monday – Friday work schedules
• Possibility of local travel
• Frequent standing, walking, sitting, lifting, bending, handling up to 10 pounds
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, and ability to adjust focus
• HOURS OF BUSINESS ARE MONDAY – FRIDAY FROM 7:00 A.M. TO 6:00 P.M.
• MUST BE ABLE TO WORK EARLY, LATE AND LONG HOURS, AS NEEDED, TO MEET THE ESSENTIAL FUNCTIONS OF THE JOB