Insurance Authorization Specialist

About the role

Obtain the necessary insurance authorizations for health services provided by the company.

Qualifications

• High School Diploma or GED required
• Two years insurance verification and/or authorization experience required
• Expert knowledge of various payers and payer insurance cards required
• Knowledge of Microsoft Office Tools (Microsoft Word, Excel and Outlook) required
• Fluency in English; written and oral communication

Responsibilities

• Complete daily authorization requirements from all hospitalizations
• Review admissions for accuracy of insurance, coordination of benefits, and status
• Obtain clinicals, diagnosis information, and ICD10 codes as necessary for completing the insurance authorization process
• Ensure insurance carrier documentation requirements are met and authorization documentation is scanned and documented in the patient's record
• Review and submit all follow-up requirements for further days certified
• Work closely with Patient Access and the Billing Department on account updates and authorization activity
• Work with Case Management on all denials and/or peer-to-peer reviews
• Maintain a good working knowledge of authorization requirements for all payors and state/federal regulatory guidelines for coverage and authorization of services provided
• All other tasks as assigned