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SouthEast Alaska Regional Health Consortium

Authorization Specialist I

Entry-Level JobVerifiedNo experience needed

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$60,240 / year median in Alaska

+19% projected growth

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Job Description

Pay Range:
$25.00 - $30.04 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 authorizations for patients in accordance with the payer-provider contracts. The Authorization Specialist is responsible for tracking and correcting all pertinent insurance information in the electronic medical record. They are expected to maintain strong working relationships with payers, SEARHC billing staff, and all other interdepartmental staff, and provide excellent customer service at all times. SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more. Key Essential Functions and Accountabilities of the Job 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 contribute to the working group's achievement of goals effectively, and to help foster a positive work environment. Protects confidentiality/privacy in verbal, written, and electronic forms of communication or information sharing. Raises concerns in appropriate manner and according to policy. Demonstrates behavior and communication skills that align with SEARHC's commitment to superior customer service, including quality, care, and concern with each and every internal and external customer. Captures and records inbound and outbound authorizations for patients and/or referring physician's offices. Carries out due diligence to obtains authorizations from various insurance carriers via phone, in writing or email. Processes authorization-related denials and coordinates the appeal process with the appropriate Revenue Cycle staff members. Ensures efficient documentation of information for insurance verification, registration and billing requirements and follows-up as needed. Responds to inquiries regarding status of authorization(s) by assessing the request and evaluating the circumstances to provide the needed information. Demonstrates superior customer service to all external and internal customers. Communicates effectively with patients, physicians, and/or other departments regarding delay or issues relating to authorizations and patient appointments. Meets team metric standards and expectations consistently. Maintains strict confidentiality at all times. Identifies compliance/ethics issues and bring forth recommendations for operational improvement. Other Functions Ensures successful adherence to policies, procedures and changes to the organization. Completes and supports additional patient access related activities as assigned. Other duties as assigned
Additional Details:
Additional Job Description Education, Certifications, and Licenses Required High School Diploma or GED - required. Experience Required Entry level position with on-the-job training provided. Experience in working in a healthcare office or customer service - preferred. Knowledge of Medical Terminology or CPT or procedure codes; alternatively, contains the willingness to learn General office functions, office equipment, and computer applications Skills in Working independently Good interpersonal, verbal, and written communication Strong attention to detail Ability to Prioritize work in multi-task in a fast-paced office setting with many interruptions Self-start and willingness to learn Read and comprehend simple instructions, short correspondence, and memos Demonstrate time-management, organizational, and customer service skills Work flexible hours with limited unplanned absence Problem-solving demeanor Effectively prioritize multiple ongoing tasks and responsibilities under pressure at a steady pace in an unpredictable environment Handle difficult customer situations in a positive manner Interact with external healthcare professionals in a variety of settings
Position Information:
Work Shift:
OT 40 If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!