Authorization Specialist I

The Authorization Specialist serves as the point of financial clearance for the Infusion Center. The Authorization Specialist obtains authorization for infusion and/or radiation service on behalf of BPE providers. The team member verifies appropriate order is received, insurance is verified, as well as request authorization on their behalf- including submission of clinical documentation. Authorization Specialists work closely with practice leadership along with department leadership regarding needs to ensure appropriate clearance. Authorization Specialists contact patients regarding rescheduling needs and communicate with ordering providers and servicing departments. Authorization Specialists verify authorizations received from external referral sources to Infusion and verify benefits of the patient. In conjunction with pharmacy partnership, Authorization Specialists communicate drug changes as needed for assistance programs. This position will work directly with practice leadership. In order to ensure superior service and appropriate patient care, all pre-appointment requirements including scheduling, authorization, price estimation, financial counseling and pre-registration will be coordinated by this position. Minimum Education High School Diploma or Equivalent Required Minimum Work Experience 1-3 years Registration, customer service, and/or scheduling experience with medical terminology experience Preferred Accountable for verification of benefits for all BH Infusion Department Services. Monitors, documents and completes any insurance authorization and/or verification (benefit) requirements. Ensure BHC has accurate and current information to process claims and to obtain payment including complete review of financial clearances. Understands all regulatory agency requirements (i.e. Joint Commission, HIPPA, EMTALA, OIG, and CMS, etc.) as it relates to software under PASS' management.