Authorization Specialist

First and foremost:

We recognize communication as our most vital tool. Every employee should focus on communicating across the system to ensure we are functioning as a team. This will require active communication with patients, team members in your department as well as other departments, managers, and physicians. You are encouraged and expected to look for ways to use communication to solve challenges and enhance the patient experience.

Summary:

The Authorization Specialist will ensure that insurance benefits are verified, patient responsibility amounts are calculated, and authorizations are obtained on all tests, injections, and surgical procedures prior to the procedure.  

Essential Functions:

Provide excellent customer service to internal and external customers through prompt response and courteous communication within 24 hours of the request. 

Verify all insurance benefits and eligibility as necessary to ensure accurate financial estimates are provided to the patient and re-verify monthly benefits if the visits spans a new month.

Assist patients with questions or concerns regarding their authorization, paperwork or payments as needed.

Obtain authorization on all necessary visits and/or surgical procedures prior to the surgery and/or procedure.

Must have excellent customer service skills at all levels of encounters with all customers

Ensure all tasking is worked daily and completely to ensure appropriate follow up is timely.

Interface with physicians and medical staff to ensure all necessary documentation is valid and complete in a timely manner in order to obtain authorizations.

Respond to and resolve difficult/sensitive inquiries and complaints; evaluate problems and take appropriate action to resolve issues and concerns.

Immediately alert scheduling and/or Physician/MA team regarding any denial of services.

Document accurately and timely in the EPM system all authorizations or interactions surrounding the insurance on every patient.

Maintain departmental goals and productivity parameters as set forth by the Director.

Other Functions:

Assist team members as needed.

Other duties as assigned.

Pay information: $20.14 to $24.80/hourly, based on experience

Education:

High School Diploma or GED         

Experience:

2 Years of collections experience in a medical office or hospital a plus.

Skills:

Excellent 10-key skills.  

Working knowledge of the EHR system.  

Insurance knowledge a plus. 

Excellent interpersonal communication skills.  

Ability to maintain quality control standards.   

Ability to meet deadlines.