Authorizations Specialist

Authorizations Specialist Department: RCM: Authorizations Employment Type: Full Time Location: Bloomfield Compensation: $25.00 - $26.00 / hour Description Authorizations Specialist Location: REMOTE or HYBRID Entity: Alliance Health System Reports To: Director of Authorizations Authorization Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers. Summary of Responsibilities & Benefits

RESPONSIBILITIES

Review chart documentation to ensure patient meets medical policy guidelines Prioritize incoming authorization requests according to urgency Obtain authorization via payer website, fax or by phone and follow up regularly on pending submission Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations Initiate appeals for denied or modified authorizations Respond to clinic questions regarding payer medical policy guidelinesConfirm accuracy of CPT and ICD-10 diagnoses in the procedure order Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of treatment authorization and its direct impact on the practice's revenue cycle Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively Proficient use of CPT and ICD-10 codes Excellent computer skills including Adobe, Excel and Internet use Detail oriented with above average organizational skills Plans and prioritizes to meet deadlines Excellent customer service skills; communicates clearly and effectively Ability to efficiently manage and prioritize time-sensitive tasks that arise

EDUCATION/EXPERIENCE REQUIRED

High School Diploma or GED 2 years medical prior authorization experience preferred 2 years experience with MD providers - Orthopedics & Pain preferred. Job Type: Full-time Monday to Friday Benefits: 401(k) matching Health insurance Paid time off Paid Holidays Background Check Requirement: Employment is contingent upon the successful completion of a background check, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law. #J-18808-Ljbffr Alliance Orthopedics