Job Description
Job DescriptionDescription:
Position Overview:
The Authorization Specialist supports the Clinical, Imaging, and Physical Therapy departments. Daily tasks will include verification of a patient’s insurance information, obtaining authorizations for, but not limited to, procedures, surgeries, injections, imaging, office visits, and pre-collection for upcoming services to be rendered. This role will also actively interact with the medical staff and patients.
ESSENTIAL FUNCTIONS:
- Authorize scheduled procedures to include surgeries, injections, medications, imaging and other items needing authorization with insurance.
- Verify eligibility and benefits for all patients and procedure codes, pre-collect payment for surgeries and other procedures as required by the department
- Ensure compliance with benefits, authorizations, and/or funding requirements and limitations.
- Confirm that all information documented in the Practice Management System is accurate.
- Document work processes as required.
- Educate staff members on authorization obligations and accountability to internal processes in a timely manner.
- Manage authorization queue by auditing daily changes and having clear documentation.
- Setup Patient tracking via tasking within the patient Electronic Medical Records System.
- Innovation of processes to facilitate the most efficient workflow.
- Document in Electronic Health Records System prior authorizations information obtained.
- Treatment authorized, date range approved for, authorization numbers and insurance company contact information.
- Must be able to recognize and respond appropriately to urgent situations.
- Follow all written protocols and procedures of the clinic including the OCC handbook, all department policy and procedures.
- Provide timely, high quality patient service and submission of authorizations, from all areas of responsibility by being courteous and helpful to all.
- Perform other duties assigned by OCC leadership.
Requirements:
REQUIRED QUALIFICATIONS AND SKILLS:
- Medical terminology, ICD-10 and CPT coding knowledge
- Knowledge of contracted insurance plans and procedures
- Solid computer and phone skills
- Strong organizational and interpersonal skills
- Ability to prioritize responsibilities and multi-task efficiently and effectively
- Adaptability to different plan and lien requirements
PAY & BENEFITS:
- Medical, Dental and Vision Insurance
- Generous PTO package and paid holidays
- Company-paid life insurance and long term disability insurance
- Ability to purchase accident insurance, short and long-term disability insurance.
- Opportunities for internal training and development
- Retirement Plan eligibility after one month of service with eligibility in company profit sharing
- Most positions offer Monday – Friday work schedules
WORKING CONDITIONS:
- Typical business office environment
- Possibility of local travel
- Constant viewing of computer monitor, mousing and typing
- Frequent standing, walking, sitting, lifting, bending, handling up to 10 pounds
- Specific vision abilities required by this job include close vision, color vision, peripheral vision, and ability to adjust focus
- Hours of business are Monday – Friday from 8:00 a.m. to 5:00 p.m. Must be able to work early, late and long hours, as needed, to meet the essential functions of the job