Authorization Specialist

Description

Reports to: Authorization Supervisor

FLSA Status: Exempt/Full-Time

Compensation: $18.00 - $22.00 per hour

Location/Travel: Based out of our corporate office in San Antonio, occasional local errands as needed

Job Summary:

The Authorization Specialist at Circle of Care is a key member of the authorization team. This individual is responsible for insurance requests and authorizations for any child covered by a insurance policy who needs our care. Working in a fast-paced, growing organization, this position is focused on the ever-growing needs of the team in line with the CofC standard of patient care. This position will rely heavily on communication, a candidate that is team-oriented and has multi-tasking abilities.

Circle of Care and Empower Behavioral Health are working together to provide quality care across a range of services. CofC provides in-home pediatric occupational, physical, and speech therapy services in Texas. EBH was created with the mission of empowering families by providing the most effective Applied Behavior Analysis (ABA) services, to ensure that learners with autism and other developmental disabilities reach their maximum potential. Together, these organizations have set out to provide the best care across pediatric occupational, physical, speech therapy, and ABA services.

Join our compassionate and knowledgeable team of professionals as an Authorization Specialist and help us grow!

Duties and Responsibilities:

• Help assess and obtain any necessary authorizations from insurance companies
• Assist with identifying performance improvement processes for efficiency – the need is great out there! Help us help children get the services they need.
• Interact with points of contact throughout the insurance companies we have contracts with to facilitate the authorization process in a timely fashion.
• Work closely with physicians and other providers to gather necessary information for the patient to obtain proper services
• Review concurrent forms and check that all supporting documents are complete and submitted.
• Participate in daily team huddles to ensure communication is optimal.
• Regularly follow up on authorization requests to keep the process moving
• Track all authorizations and monitor timelines to escalate cases as needed
• Promote the mission, vision, and values of Circle of Care
• Additional duties that are assigned to the authorization department

Requirements

Competencies:

• Attention to detail
• Excellent oral and written communication
• Results Oriented
• Customer Focus
• Problem -Solving
• Organizational Skills

Education and Experience:

Required:

• Associate degree or equivalent; or a minimum of 1 to 3 years of insurance and authorization-related experience
• Knowledge of Microsoft Outlook, Office, Word, and Excel and EMR experience, teams
• Experience with commercial/Medicaid insurance payors, authorizations, and credentialing
• Experience with communicating with insurance companies
• Previous knowledge/work in a medical office
• Experience working in a clinical based environment

Preferred:

• Minimum of one year experience in an authorization/insurance role
• Previous knowledge/work in a medical office
• Ability to speak both English and Spanish fluently
• Experience working with medical terminology
• Experience working in a growing fast paced organization

Empower Behavioral Health and Circle of Care provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.