Description:

Job Summary:

As an Authorization Specialist you are an employee of the Finance Department and a member of the Billing Team. You will be responsible for verifying insurance coverage and obtaining appropriate insurance authorizations and re-authorizations for appointments and biologics. This will be a hybrid role with three days required onsite in Sugarloaf and two days remote.

Essential Functions:

Completes all required authorizations for biologics, surgeries and office visits in a timely manner by contacting insurance companies by phone or online portals. Establish and maintain communication with assigned clinics to ensure all authorizations, verification of benefits and reporting are timely. Communicate with patients on all medication approvals and denials Prepares all necessary paperwork to submit to insurances to obtain approval for prescribed medication and ensure timely delivery for patients Ensures all insurance benefits, authorizations and client information are documented efficiently in EMR system and keeps system up to date. Contact clients with inactive insurance coverage to obtain and update insurance information. Validates coordination of benefits between insurance carriers. Provides information to insurance companies to facilitate approval and documents authorization details in patient record. Maintains patient record confidentiality in accordance with HIPAA, complying with practice policies and procedures. Support the Finance Dept. (which includes the Billing Team) as needed. Perform daily office duties. Perform all other duties as assigned.

Requirements:

Education, Experience, and Skills:

Experience with Modernizing Medicine is a plus. EMR experience is required. Experience in dermatology is a plus. Experience with biologics is a plus. Previous experience with managed care, Medicaid and commercial payors highly preferred. Excellent verbal and written communication skills. Excellent organizational skills and attention to detail. Excellent time management skills with proven ability to meet deadlines. Possess a strong working knowledge of Microsoft Office.

Physical Requirements:

Prolonged periods sitting at a desk and working on a computer. Must be able to lift a minimum of 15 pounds at times.