Verification Authorization - Associate
Caris Life Sciences
Join Caris Life Sciences
At Caris, we understand that cancer is an ugly worda word no one wants to hear, but one that connects us all. That's why we're not just transforming cancer carewe're changing lives.
We introduced precision medicine to the world and built an industry around the idea that every patient deserves answers as unique as their DNA. Backed by cutting-edge molecular science and AI, we ask ourselves every day: "What would I do if this patient were my mom?" That question drives everything we do.
But our mission doesn't stop with cancer. We're pushing the frontiers of medicine and leading a revolution in healthcaredriven by innovation, compassion, and purpose.
Join us in our mission to improve the human condition across multiple diseases. If you're passionate about meaningful work and want to be part of something bigger than yourself, Caris is where your impact begins.
Position Summary
Our Verification Authorization Associates are responsible for verifying active insurance coverage, obtaining all necessary facility and specimen collection information to bill in accordance with CMS regulations as well as contacting insurance companies to secure preauthorization required for patients to receive our services and contacting facilities for Medical Records when necessary. We need individuals to ensure information obtained is complete and accurate, follow up on requests, and apply acquired knowledge of Medicare, Medicaid, and other Third-Party Payer requirements.
Job Responsibilities
- Proficient in and exceeding job responsibilities of Verification/Authorization Personnel -Specialist either through Caris or with a former employer in a similar industry.
- Identify ways to improve and promote quality and monitor your own work to ensure quality standards are met.
- Answers provider, facility and staff questions surrounding insurance authorization requirements.
- Manage and assign daily/weekly tasks based on business need.
- Occasional peer-to-peer training.
Required Qualifications
- High School degree or equivalent required.
- 2+ Years of office setting experience.
- Proficient in MS Office (Word, Excel, Outlook)
- Demonstrates solid time management skills and organization
- Ability to work with minimal guidance; Proactive, motivated self-starter
- Flexibility and proven ability to handle and manage frequent changes effectively and efficiently
- Strong knowledge of insurance processing, guidelines and general laws related to all payers.
- Proficient in clinical documentation review for alignment with insurance authorization requirements
- Strong Problem-Solving skills
- Maintains compliance with HIPPA and other healthcare regulations
- Moderate knowledge of CPT, ICD-10
Preferred Qualifications
- Minimum bachelor's degree and 3 years of experience in a related industry or 5 years of experience in a related industry
- Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
- Drive for Results (Service, Quality, and Continuous Improvement) - Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
- Communication - Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization to achieve the desired results.
- Teamwork - Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
- Customer Service Focus - Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.
Physical Demands
- Must possess ability to sit and/or stand for long periods of time.
- Must possess ability to perform repetitive motion.
- Ability to lift up to 15 pounds.
- The majority of work is performed in a desk/cubicle environment.
Training
- All job specific, safety, and compliance training are assigned based on the job functions associated with this employee.
Other
- Willingness to work shift work and overtime.
- Job may require occasional weekends, evenings, and/or holidays.
Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check (applicable for certain positions) and reference verification.
This job description reflects management's assignment of essential functions. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
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