Authorization Specialist I

Patient Engagement Authorization Specialist I (IAS II)

The Patient Engagement Authorization Specialist I (IAS II) is responsible for financially securing Ambulatory, Ancillary, Surgical and Procedural services. This includes securing referral and authorization. Insurance verification and benefit interpretation to discern insurance guidelines are being adhered to. Ability to interact with patients and stakeholders for the successful financial clearance will be critical to be successful in the compliance of authorization and referral guidelines. Position requires ability to work in a high-volume, fast paced environment. Understanding of complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application and authorization portals to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services.

Education

• Associates Degree; Bachelor Degree preferred

Licensure, Certification & Registration

• CHAA (or acquired within 2 years of hire)

Experience

• Winning customer service personality with ability to engage patients, provider and provider staff as well as insurance company representatives via telephone with superior patient experience.
• 3 5 years' experience in Hospital or Physician office experience or call center environment, preferred
• Strong insurance knowledge specific to complex scheduling needs and authorization management

Skills, Knowledge & Abilities

• Proven customer service skill with ability to exceed expectations
• Demonstrated knowledge payer authorization requirements
• Strong attention to detail
• Ability to multi-task in stressful and high patient volume unit
• Must be able to manage pressure of very tight timeframes to execute task
• Ability to learn in classroom, utilizing resources
• Ability to remain composure under pressure
• Ability to train and onboard colleague
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; escalate issues as needed
• Team minded work ethic
• Demonstrated ability to interpret patient's insurance benefits and apply the applicable contractual obligations
• Critical thinking ability regarding issues with financially securing payment

Thank you for your interest in Albany Med Health System! Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.