Authorization Specialist I or II - Sign On Bonus!

Pay Range & Incentives Pay Range: $25.00 - $33.71 per hour. Sign‑on bonus: $1,000 at start and $1,000 bonus after 12 months for qualified hire. Position Overview The Authorization Specialist works with payers and SEARHC clinical staff to obtain initial and ongoing authorizations for patient services, verifies insurance benefits for each patient, and obtains authorizations for patients in accordance with payer‑provider contracts. The role is critical for reimbursement of costs relating to high‑dollar procedures and services. Key Responsibilities Track and correct all pertinent insurance information in the electronic medical record. Maintain strong working relationships with payers, SEARHC billing staff, and all interdepartmental staff; provide excellent customer service. Accurately capture and record inbound and outbound authorizations for patients and/or referring physician’s offices. Obtain authorizations from various insurance carriers via phone, in writing or email; conduct due diligence. Process authorization-related denials and coordinate the appeal process with appropriate Revenue Cycle staff members and clinical team. Work closely with the Financial Counselors and Patient Access team to ensure coverage is current and documented appropriately in the record. Ensure efficient documentation of information for insurance verification, registration and billing requirements; follow‑up as needed. Respond to inquiries regarding status of authorization(s) by assessing the request and evaluating circumstances to provide the needed information. Communicate effectively with patients, physicians, and other departments regarding delays or issues relating to authorizations and patient appointments. Meet team metric standards and expectations consistently; maintain strict confidentiality at all times. Identify compliance or ethics issues and recommend operational improvements; ensure adherence to policies and procedures. Complete and support additional patient access related activities as assigned. Essential Functions & Accountabilities Knows, understands, incorporates, and demonstrates the Mission, Core Values, and Vision in behaviors, practices, policies, and decisions. Maintains collaborative, team relationships with peers and colleagues to achieve group goals and foster a positive work environment. Protects confidentiality/privacy in verbal, written, and electronic communications. Raises concerns appropriately according to policy. Consistently exhibits behavior and communication skills that demonstrate SEARHC’s commitment to superior customer service, including quality, care, and concern with each and every internal and external customer. Qualifications High School Diploma or equivalent (required). CHAA Certification within 6 months of hire. Two years of experience as an Authorization Specialist or in a healthcare, office, or customer service setting (preferred). Knowledge of tribal health programs and alternate resources. Knowledge of customer service principles. Proficiency in data entry, retrieval, and reporting. Knowledge of Medical Terminology; ICD-10-CM, CPT & HCPCS codes; Insurance authorization and benefits; Anatomy and physiology. General office functions, office equipment, and computer applications. Strong attention to detail and above-average organizational skills. Effective oral and written communication skills. Database and software application proficiency. Ability to work independently and as part of a team. Good interpersonal, verbal, and written communication. Ability to multitask and work independently in a fast‑paced environment. Responsiveness in urgent situations with attention to detail. Problem‑solving and conflict resolution skills. Prioritization under pressure and while handling interruptions. Self‑start and willingness to learn. Capability to read and comprehend simple instructions, short correspondence, and memos. Demonstrated time‑management, organizational, and customer service skills. Flexibility to work hours with limited unplanned absence. Ability to handle difficult customer situations positively. Interaction with external healthcare professionals in various settings. Maintain professional demeanor with physician and clinical team when addressing concerns regarding imaging orders/diagnoses. Benefits We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance, long‑term and short‑term disability, and more. Work Shift Work Shift: OT 8/40. #J-18808-Ljbffr