Authorization Specialist

Job Description

Job Description

Pay: $22-25/hour
Schedule:  Monday through Friday 8:30AM - 5:00PM
Requirements: 

• High school diploma or equivalent
• 1+ year of insurance verification experience is required
• 1+ year of authorization experience is required
• Knowledge of current ICD and CPT guidelines
• EMR experience (practice uses eClinicalWorks, NaviNet, Helio – training provided)
• Orthopedic/Pain Management experience highly preferred

Responsibilities:

• Responsible for monitoring incoming patient orders and gathering information needed to complete the pre-authorization and scheduling for an order
• Obtain authorizations for all diagnostic imaging, orthotics, DME, EMG studies, and hyaluronic acid injections directly or by submitting documentation to facility or vendor
• Contact patients as necessary to advise on scheduling
• Direct and timely contact with providers, MAs, PCCs, in regard to patients authorization status
• Review and notify provider of denials, appeal as needed, assist in setting up peer-to-peers
• Perform verification of patient's insurance preferred drug prior to authorization request
• Obtain and coordinate delivery of injection medication from pharmacy for all commercial insurance and physicians in the practice
• Ensure all verification of customers insurance benefits is completed and updated
• Notify customers of deductibles, authorization approvals and co-insurance due
• Regularly call insurance companies to follow up on patient status and claims
• Always keep sensitive customer and company information confidential
• Contact customers to obtain any outstanding information
• Learn and understand all aspects of revenue cycle responsibilities and participate in a cross-training session
• Coordinate authorizations for customers with PIP claims
• Cross-train to support and perform all aspects of back office and cover other assignments when requested by management
• Receive calls related to authorizations, whether from patients or insurance companies
• Review incoming telephone encounters
• Review incoming faxes

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