Medical Authorization Specialist

Duties and Responsibilities

• Responsible for filing prior authorization requests for all insurances that require based upon plan or insurance contract.

• Must request, obtain, and document (within current software) all prior authorization - in an appropriate and timely manner.

• Obtain information about patient insurance coverage, benefits, and eligibility.

• Assists as needed with collection activities on accounts involving prior authorization activity. Including accepting phone calls related to prior authorization questions from patients & staff in all states.

• Maintains the strictest confidentiality in accordance with HIPAA regulations and clinic requirements.

• Perform other responsibilities as needed or required.

Performance Requirements

• Requires a high school diploma or GED.

• Must have a thorough knowledge of the insurance industry and operational procedures required by individual insurance companies by virtue of the contracts that each center has entered.

• Requires attention to detail, knowledge of health insurance carrier operations, including but not limited to; third-party administrators, fee schedules, and spectrum of health insurance products, including Medicare, Medicaid, commercial and HMO plans.

• Requires knowledge of health insurance benefits and application of the same. Such as; co-payments, deductibles, co-insurance, out-of-pocket maximums, etc.

• Skilled in the use of computers. Including; the ability to utilize spreadsheets, the ability to navigate the internet and websites and basic use of a calculator.

• Knowledge of CPT and ICD-9 coding practices and procedures.

• Must have strong interpersonal skills to establish and utilize working relationships internally and externally within the health insurance community and company.

• Ability to work effectively with co-workers as a team member

• Strong written and verbal communication skills.

Performance Criteria

• Demonstrates interpersonal skills as discerned through observation of professional dealings with patients, coworkers, visiting representatives and management.

• Thoroughly and accurately completes all paperwork and computer processes related to ensuring the completion and accuracy of all medical records.

• Communicates in a professional manner to all of whom you come into contact with. (Supervisors, patients, visiting representatives and coworkers)

• Contributes to company success by lending time and effort as requested by direct supervisor(s) such as filling in for absent team members.

• Efficiently prioritizes and organizes workflow, as determined by direct supervisor.

• Maintains the highest patient confidentiality required by HIPPA.

• Engages in all time-sensitive tasks with appropriate levels of urgency and accuracy.

• Maintains punctuality and acceptable attendance, per company policy.

Job Type: Full-time

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday

Application Question(s):

• Please provide a good email to reach you at

Experience:

• Medical billing: 1 year (Preferred)

Work Location: In person

Salary : $20