Verification/Authorization Specialist (Epic experience required)

Verification/Authorization Specialist

FlexStaff is seeking a full-time Verification/Authorization Specialist for our client in Garden City, NY.

In person from 8:00 AM4:30 PM or 9:00 AM5:00 PM (hours may vary)

Assignment Length: Expected to last 26 months, with the potential to convert from Temp-to-Perm

Job Summary:

The role responsible will be responsible for all aspects of the prior authorization process. Responsibilities include collecting all the necessary documentation, contacting the client for additional information and completion of the required prior authorization in order to proceed with testing. Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors. Interacts with clients, insurance companies, patients, and sales representatives, as necessary, to request for prior authorizations.

Essential Functions:

1. Ensure all pre-authorizations have been approved with the proper procedure code prior to service being rendered. In addition, have the ability to work with technology necessary to complete a job effectively.

2. Ensure that ICD10 diagnosis codes are entered by all Therapists correctly.

3. Input authorizations and updating miscellaneous screens to ensure authorizations are processed.

4. Provides data entry for proper level of care which has been arranged by the Authorization received from funding sources.

5. Contacts providers and patients with authorization, denial, appeals process information, and provides other therapy options.

6. Maintain robust documentation of authorization processes and procedures.

7. Assist patients, site staff, and management with authorization issues.

8. Collaborates with other departments to receive and process authorization forms.

9. Uses good documentation skills to document process and procedure as well as conversations with clients and insurance carriers.

10. Generate "expected collections" report to notify patients of cost responsibilities. In addition, make corrections on patient accounts when errors are identified.

11. Maintain referred physician National Provider Identifier (NPI).

12. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

13. Performs other duties and assignments as required.

Qualifications:

• High school diploma or GED is required.
• 3 years of experience in the field or in a related area.
• Strong customer service skills; ability to diffuse client frustrations.
• Current or recent experience in a medical practice ensuring compliance with federal, state and local regulations and guidelines.
• Must work well within a team environment.
• Excellent interpersonal and communication skills
• Proficiency in Word, Outlook, and Excel.
• Ability to use logic and problem-solving skills to resolve issues and navigate between dual monitors.
• Ability to work independently under tight deadlines in a rapidly changing environment.
• Ability to handle stressful situations resulting from high volume of phone calls, technical problems, frustrated customers and changes in departmental priorities or procedures.

*Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).