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AUTHORIZATION SPECIALIST
Job
Region Ten Community Services Board
Charlottesville, VA (In Person)
$49,681 Salary, Full-Time
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Job Description
Req# 22000041 GENERAL
STATEMENT OF RESPONSIBILITIES
This is a FLSA non-exempt position. The incumbent serves as administrative staff with specialized responsibilities for the Financial Access Department of the Administrative Division. In this capacity, he/she has primary responsibilities for requesting service authorizations to various insurance companies in a timely manner to obtain approval for the agency to provide service to clients. The incumbent is under the direct supervision of the Fiscal Access Program Manager. The incumbent performs duties by proceeding alone under standard practices and referring questionable situations to the supervisor. Standard practices allow for the independent accomplishments of recurring tasks and use of own initiative for prioritizing the work schedule. Work includes ad hoc problem solving around assigned tasks. In carrying out position duties, he/she performs in accordance with applicable professional ethics and established Region Ten policies. Position performance requires analysis of facts and determining action using a wide range of procedures but within the limits of standard practice. Duties require planning own work after definite objectives set by the supervisor with unusual situations referred to the supervisor. The essential functions of this job are starred below (- ) under "Major duties.
MAJOR DUTIES
1.- Request and obtain service authorizations from various insurance companies, using fax, internet, and/or phone to submit requisite clinical information to payers for review. 2.
- Effectively respond to insurance companies' time-sensitive requests for additional information in order to maximize agency's service approvals. 3.
- Accurate and timely data entry of authorizations approval into Credible once obtained from insurance companies. 4.
- Assist clinicians in tracking and/or updating external authorizations by providing information to clinicians in a timely manner. 5.
- Issue service limit and/or date expiration warnings to staff and management notifying them of over and/or underutilization. 6.
- Manages clinicians' internal request for submitting authorizations. 7.
- Notify supervisor of issues related to clinicians' request and/or insurance companies. 8.
- Notify supervisor of any changes to payer rules and/or procedures noticed while submitting requests. 9.
- Collaborates with other agency staff and functions in assuring accurate reimbursement related data entry. 10.
- General secretarial duties as they relate to the authorization request process (i.e., copying, typing, faxing, and filing). 11.
- Reads all agency communication. 12.
- Other duties and special projects as assigned by the supervisor.