Authorization Specialist

Company Description Here at IPA Management Partners, we are changing the pain journey by treating every patient with an individualized care plan that is just as unique as they are. By reimagining what is needed, and implementing specialized groundbreaking technology, we deliver proven maximum effective results, with minimally invasive pain management procedures. At IPA Management Partners, we are committed to providing jobs that deliver opportunity and growth in a progressive, exciting, and fast‑paced work environment. We are committed to serving in fairness, dignity, and respect, and to providing an environment which affords opportunity and success. If you are looking for your next career opportunity, we have one waiting for you in Killeen, TX! Details The Authorization Specialist processes all orders placed by IPA providers for patients, across the pain management specialty, from order to completion, while serving as the liaison between our providers, insurance carriers and rendering care facilities. The ideal candidate will also serve as the primary point of contact for each patient as it pertains to orders placed. Duties and responsibilities Ability to respond to all work correspondence in a courteous and professional manner Utilize EMR system fax line and pull reports and patient records for department Obtain prior authorization through insurance portals and external authorization departments based on provider orders Insurance verification Review clinical documentation to ensure it supports the insurance requirements for approval Completion of appeals and processing Peer to Peer Requests for denied procedures Direct all communication and concerns to direct supervisor Copy appropriate recipients on all work‑related emails and EMR telephone encounters Accurately notate accounts with actions taken as it relates to prior authorizations, follow ups, and scheduling Respond accurately to staff inquiries in a professional manner related to the precertification Department Process all orders within a reasonable timeframe and continually check status for updates Ability to take and make calls from patients and insurance companies within a reasonable time frame Maintain high priority tasks, messages, emails daily and throughout the day Format all authorization documents correctly and verify for accuracy prior to submission Notify appropriate departments in advance of any issues that may arise regarding authorization submission Additional tasks assigned by Supervisor or Executive Management You will love it here if you have: Previous knowledge/experience obtaining prior authorizations for surgical procedures. Familiarity with various insurance programs: Medicare, Medicaid, HMOs, Commercial payers Strong, professional communication skills Ability to type a minimum of fifty (50) words per minute. Positive attitude and adaptable to change. Strong internal and external customer service skills Basic medical terminology Knowledge of HIPAA and Patient Rights guidelines Ability to follow all Federal, State and Local regulations. Ability to enter data professionally into the Glo EMR system. Knowledge of CPT and ICD10 codes Required Skills/Abilities Two (2) years of prior authorization experience Previous knowledge/experience processing outgoing referrals Knowledge of CPT and ICD10 codes Ability to work 40 hours weekly Strong, professional communication skills Professional appearance Team player with exceptional attendance Ability to type a minimum of fifty (50) words per minute Positive attitude and adaptable to change Strong internal and external customer service skills Basic medical terminology Knowledge of HIPAA and Patient Rights guidelines Ability to follow all Federal, State and Local regulations Education and Experience High school or equivalent (Preferred) CPT and ICD10 Code: 1 year (Preferred) ECW EMR system: 1 year (Preferred) Insurance Eligibility and Authorization portals such as Availity, Carelon, Evicore: 1 year (Preferred) Specialty practice experience: preferably in pain management but not required. Bilingual, a plus, but not required. Working conditions Frequent sitting, writing, typing, and speaking Occasional standing, walking, reaching, bending, lifting, and carrying Lifting and carrying up to 25 pounds Frequent use of computer, keyboard, copy/fax machine, and phone Schedule Monday-Thursday, 8am - 5:00 pm Friday, 8am - 2pm 3 Medical plans to choose from 2 Dental plans to choose from A Vision Plan Company-provided life and accidental death & dismemberment (AD&D) insurance. Options to increase Life and AD&D insurance for yourself and your family Short-Term Disability Long-Term Disability Telemedicine, Behavioral Health and medical bill auditing and redirection of medical care via Advocacy Bi-lingual is a plus. Integrated Pain Associates in an Equal Opportunity Employer EEO AA M/F/Vet/Disability. Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, protected veteran status or disability. #J-18808-Ljbffr