Authorization Specialist

Authorization Specialist - Centennial, CO

Compensation: $21 - $25 hourly

Nexus HR is looking for an exceptional and meticulous Authorization Specialist for a reputable immunology clinic in Colorado. The ideal candidate will have a solid understanding of accounting and financial processes and laws, and good computer and verbal, and written communication skills.

About the Job

The Authorization Specialist is directly responsible for assisting with care coordination for all patients. As the first point of contact for all new patients, the care coordinator directly controls the patient experience by assisting patients through the intake, insurance authorization, provider care requirements, and coordinating and scheduling of the first appointments. In conjunction with the patient engagement team, medical staff, and billing support, the patient coordinator will navigate and resolve any issues that would prevent new patients from obtaining care on time.


Duties and Responsibilities:

• Assist patients through intake, insurance authorization, and provider care requirements.
• Communicate with patients starting new therapies and provide necessary information and support resources.
• Obtain required medical records and complete the authorization checklist.
• Coordinate with the clinical team to confirm necessary items before submitting orders to insurance.
• Manage peer-to-peer appointments or appeals and monitor daily open and pending orders.
• Schedule appointments, follow-up appointments for denied therapies, and handle copay assistance.
• Maintain regular communication with patients, clinical teams, and authorization teams to streamline processes.
• Contribute to continuous process improvement and uphold patient confidentiality and organizational standards.

Qualifications :

• At least 2 (two) years of medical authorization experience is required
• Exceptional analytical skills are necessary to perform various data analysis techniques, and review statistical data for departmental planning and control, in the preparation and maintenance of budgets, and problem-solving.
• Must possess interpersonal and communication skills (both oral and written) to provide effective participative leadership and to interact with patients, families, physicians, and other visitors and staff.
• Strong problem-solving skills.
• Proficiency with Microsoft applications.
• Proficient in current healthcare technologies, including health charting software and equipment.
• Able to work on-site in Centennial, CO