Authorization Specialist

Location 75A Livingston Street,Livingston St PT Office,Asheville, NC, 28801,United States Job Category Therapy Employee Type Full-Time Manage Others No The Authorizations Specialist is responsible for obtaining and applying all required authorizations, enabling the appropriate compensation for medical claims. Confirms patients’ insurance eligibility while obtaining authorization. The specialist acts as a liaison between referring physicians’ offices, case managers, adjusters, and social workers to obtain required authorizations. This position will assist with our physical therapy department with Insurance Authorizations. Qualifications and Experience High school diploma or equivalent Previous experience in insurance billing and coding Minimum two years of patient service experience in a healthcare setting Ability to act with integrity, professionalism, and confidentiality Experience using electronic medical records systems Excellent communication and interpersonal skills Excellent organizational skills and attention to detail Responsibilities include, but are not limited to the following Obtains orders from the physician Log all orders in EMR for accurate tracking and scheduling Eligibility, benefits, and authorization are obtained online or via telephone Respond to clinical requests by providing accurate information. Perform follow-up calls within 3 business days regarding the authorization status If a peer-to-peer review is needed prior to obtaining authorization, we will schedule with our physician and the insurance carrier’s Medical Director If the request is to have the patient be sent to an outside physician for treatment the office notes, patient demographics, and insurance card(s) are faxed to the outside physician’s office for an appointment Follow up on requests within 7-10 days to confirm accurate information has been received and confirm an appointment has been made Work diagnostic orders within 3-5 days of receipt. STAT orders are worked on immediately Obtain surgical authorizations 10 days prior to the surgery date unless the surgery is scheduled as a STAT Maintain the electronic log sheet, generated for physical therapy patients indicating patient demographics and therapy caps Maintains clinic and patient confidentiality Performs other duties as required and assigned by Manager, including schedule changes and travel to office locations as assigned EmergeOrtho, P.A. complies with applicable civil rights laws and does not discriminate based on race, color, religion, national origin, age, sex, gender identity or expression, sexual orientation, pregnancy, childbirth and related conditions, including but not limited to, lactation, disability, veteran status, genetic information, or any other class protected by the state or local law. Note: Available benefits based on hours worked per week. #J-18808-Ljbffr Mt. Washington Pediatric Hospital