Authorization Specialist

Job Description

Job Description

Authorization Specialists are responsible for providing exceptional customer service, collecting insurance information, ensuring correct benefits, and securing authorizations to help our families maintain coverage for services. Responsibilities Essential Functions
• Confirm Insurance Coverage
• Determine necessity for pre-authorization and obtain authorization for scheduled patients
• Helps perform eligibility checks for ongoing patients
• Provide standardized documentation within system to identify prior authorization and the criteria surrounding such authorization accurately and timely
• Notify patients and/or clinical staff of any services requested and/or referred that are not authorized by insurance.
• Contact physician offices via fax and/or phone to obtain information necessary to secure an authorization
• Contact insurance offices via fax, portals, and/or phone to obtain authorization
• Monitor all tasks using workflow software and meet the deadlines associated with tasks.
• Advise clinical staff when issues arise relating to obtaining prior authorization
• Adhere to policies and procedures of Hopebridge
• Assist with problem solving to improve efficiency and morale within the office
• Portray a positive attitude and maintain a customer and co-worker satisfaction level that limits adverse situations or complaints
• Promote Hopebridge philosophies, generating team spirit and creating and maintaining and environment that fosters staff satisfaction, maximizes productivity and profitability
• Attend weekly meetings and training as requested
• Other duties as assigned Required Skills Competencies
• Proficient Computer Skills
• Strong Attention to Detail
• Collaborative Attitude with Others
• Ability to Identify and Solve Problems
• Mission Driven Commitment to the Job
• Frist-Class Customer Service Skills
• Self-Driven Time Management skills
• Ability to Handle Stress in Fast Paced Environment
• Ability to Multi-task and ability to support multiple priorities

Position Type and Expected Hours of Work
Flexibility in hours is allowed, but the employee must be available during the “core” work hours of 7:00 a.m. to 5:00 p.m.

Required Education and Experience
• Must be at least 18 years of age
• Possess a minimum of a high school diploma

Preferred Education and Experience
• Healthcare experience preferred but not necessary
• Healthcare terminology preferred
• Salesforce experience preferred

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Physical Demands
This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. Employees in this position must be physically able to efficiently perform the essential functions of the position.

Work Environment:
Work is performed in an office environment. Work may be stressful at times due to a busy office. Interaction with others is constant and interruptive.

Disclaimer
The above statements reflect general functions of this job and shall not be construed as a detailed description of all work requirements inherent in this job. The immediate supervisor may elaborate on or add to the above list if the duties come within the employee’s realm of responsibility.

Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, arrest record or any other characteristic protected by applicable federal, state or local laws.