* Authorization Specialist * ($1,000 Sign On Bonus!)

Job Description

Job Description

Overview

This position verifies insurance coverage, benefits and obtains prior authorization for services.

$1,000 sign-on bonus available (terms apply)
Bonus paid after 90 days; repayment required if employment ends within 6 months.

Responsibilities

MAIN:

1. Contacts insurance plans to determine eligibility and obtain coverage and benefit information.
2. Obtains prior authorization for services.
3. Processes requests for prior authorization for surgery and/or procedure injections
4. Identifies and resolves problems with participant eligibility/insurance coverage
5. Accurately calculates patient responsibility amounts based on benefit information and payer allowable.
6. Documents findings thoroughly and accurately.
7. Prioritizes work to maximize turn-around time.
8. Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
9. Maintain an error rate in accordance with departmental policy.
10. Makes changes to demographic information as necessary in order to produce a clean patient statement.
11. Answer and respond to external and internal phone calls in a timely manner.
12. Check and respond to emails in a timely and professional manner.
13. Performs all other assigned duties.

GENERAL DUTIES:

1. Conducts self in accordance with the company’s standard values and policies.
2. Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels.

The Essential Job Functions and Duties and Responsibilities listed above are not exhaustive.  The job functions and duties of this job may vary depending upon the specific nature and needs of the department, including size, location and services offered.  At some locations, employees may not perform all of the job functions or duties listed above.  At other locations, employees may perform some or all of the job functions or duties listed above and, in addition, may be required to perform other job functions or duties as directed. In addition, given the nature of its business, MMRG retains the right to modify the essential job functions and duties of this position at any time.

METHOD AND FREQUENCY OF SUPERVISION:

• Monthly meetings with supervisor. Informal supervision with employee through an open door policy.  Employee is expected to ask questions when needed.

The expected pay for this role is up to $26 per hour. Final compensation will be based on factors such as relevant experience, skills, internal equity, and market data.

Qualifications

Education:

• High School diploma or equivalent

Prior Experience:

• Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience required experience preferred.

Skills and Proficiencies:

• Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
• Demonstrated computer literacy
• Well-organized with attention to detail
• Ability to read and understand oral and written instructions
• Excellent math skills
• Critical thinking skills are strongly preferred
• Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
• Professional customer service skills.
• Have a desire and dedication to work with self-discipline.
• Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Physical Abilities:

• Ability to sit for long periods. Work requires walking, bending, standing, sitting, and reaching