Authorization Specialist Job type

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Full-time Position Summary :

Responsible for obtaining benefits, verifying insurance information and pre-authorizations for services from various insurance companies in a timely manner and appropriately documenting the information in the patient's electronic medical record to ensure accurate billing and timely collection of outstanding accounts receivables.

Essential Functions:

Core duties include the following, but are not limited to:

• Collects patient's demographics and insurance information.
• Knowledge and understanding of co-insurance, co-payments, deductible, and out-of-pocket costs.
• Verifies health insurance eligibility and obtains benefit information.
• Communicate with insurance carriers for purposes of obtaining approval (authorization) for services requiring pre-certification and/or prior approval, including initial authorizations for office visits.
• Processing requests for pre-certification and/or prior authorization, as directed.
• Accurately update the patient's medical record with actions taken on the request for pre-authorization.
• Notifying the medical assistant and/or Physician of any referral/pre-authorization requests requiring additional justification and/or medical decision making.
• Reviews and works assigned tasks in EHR system.
• Other duties as assigned by management.

Skills, Knowledge and Abilities:

Working knowledge of the following:

• Healthcare, Ophthalmology (a plus)
• Medical Terminology
• Grammar, spelling, and punctuation
• Knowledge of EHR
• A variety of computer software applications including Microsoft Word, Excel, Outlook
• Exceptional Customer Service
• Credentialing knowledge (a plus) Ability to:
• Maintain effective and organized systems to ensure timely patient care
• Problem Solve, prioritize
• Multitask and detail-oriented
• Work independently as well as a in a team environment
• Communicate effectively verbally and in writing
• Communicate effectively with patients, co-workers and physicians Additional Information Competitive salary and full benefits offered with this position.

Qualifications:

High school graduate or equivalent Insurance verification 1 year required Medical terminology: 1 year required Medical billing or related revenue cycle experience: 1 year required Knowledge of medical services coding Knowledge of insurance carrier requirements and policies for pre-authorization for services

• Fast paced, detail-oriented health care environment

Job Type:

Full-time Benefits:

401(k) Dental insurance Disability insurance Health insurance Life insurance Paid time off

Education:

High school or equivalent (Preferred)

Experience:

Insurance verification: 1 year (Preferred) Medical billing: 1 year (Preferred)

Work Location:

In person