Insurance Authorization Specialist

Insurance Authorization Specialist

The purpose of this position is to obtain the necessary insurance authorizations for health services provided by the company.

Essential Job Functions:

• Complete daily authorization requirements from all hospitalizations
• Reviews admissions for accuracy of insurance, coordination of benefits, and status
• Obtains clinicals, diagnosis information and ICD10 codes as necessary for completing the insurance authorization process
• Ensures insurance carrier documentation requirements are met and authorization documentation is scanned and documented in the patient's record.
• Review and submit all follow-up requirements for further days certified.
• Works closely with Patient Access and the Billing Department on account updates and authorization activity.
• Works with Case Management on all denials and/or peer to peer reviews
• Maintains a good working knowledge of authorization requirements for all payors and state/federal regulatory guidelines for coverage and authorization of services provided.
• All of tasks as assigned.

Basic Qualifications:

• High School Diploma or GED required
• Two years insurance verification and/or authorization experience required
• Expert knowledge of various payers and payer insurance cards required
• Knowledge of Microsoft Office Tools (Microsoft Word, Excel and Outlook), required
• Position requires fluency in English; written and oral communication