Intake/authorization Specialist

1 week ago

Houston, United States Lymphedema Therapy Specialists Full time

**About us**

At Lymphedema Therapy Specialists, we ‘live to serve’. The patient population we serve is in such need of the comprehensive treatment LTS provides. They are like family to us, and so is our entire team. You will find that the work you will do at LTS will provide you with a true sense of purpose and satisfaction, as you will be contributing to our company mission, which changes the lives of those who walk through our doors.

Our Intake/Authorization team works through the insurance process with passion and is dedicated to getting every patient the care that they need. We are looking for an experienced Intake/Authorization Specialist whose primary responsibility will include verifying insurance and eligibility information, obtaining authorization/referrals, and ensuring a smooth transition for new and current patients, while addressing patient inquiries with empathy and professionalism.

We are looking for someone who is a team player, dependable, diligent, and will go above and beyond for our patients, while ensuring accuracy and attentiveness in all they do.

**Qualifications & Skills**
- Proficiency in Microsoft Outlook, Word, and Excel, Google Sheets;
- Strong organizational and attention to detail skills;
- Ability to work independently and collaboratively within a team;
- Adaptability to prioritize tasks effectively;
- Knowledge of medical insurance and authorization processes;
- Knowledge and skills in working with computerized billing systems, including practice management software and EMR;
- Proficiency in medical terminology and experience working in a healthcare or insurance setting;
- Must adhere to all HIPAA guidelines and regulations.
- Experience in AdvancedMD is a Plus+.

**Responsibilities**
- Responsible for answering incoming calls from other providers, recipients, and carriers, and LTS staff regarding insurance coverage.
- Responsible for effective and efficient verification of all patients’ benefits before their appointment, and during the course of all treatment.
- Responsible for obtaining all referrals and authorizations for all pumps and services, as required.
- Ensure all patient questions are answered and issues are resolved timely by utilizing the appropriate resources.
- Research eligibility information online with various insurance carriers.
- Verify member’s eligibility and benefits with subsequent notification to designated staff of eligibility issues.
- Prepare and send authorization appeals within a timely manner to insurance/carriers for services, treatment, and pumps.
- Notify required parties within the appropriate timeframe for routine and urgent requests for services.
- Research member history for duplications and consideration of authorization limits and pumps.
- Verify fax numbers and system updates. Communicate with the requesting provider for any identified need to clarify a request for an authorization (ie. CPT codes, ICD10, requested timeframes and member’s demographics).
- Forward each authorization to appropriate department staff in terms of eligibility and other coverage, pricing, and benefit issues.
- Scan, attach, review, and effectively work with electronic images as part of the authorization process. This includes recording the required information from attachments into the authorization fields and uploading into chart files.
- Collaborate with Revenue Cycle Manager and Clinic Managers, to resolve complex authorization issues.
- Appropriately forward all referral requests to the next level of clinical review as applicable and after verifying for completeness and appropriateness.
- Maintain appropriate logs, records, and reports as established by LTS: Revenue Cycle Department.
- Document and communicate areas of concern to department supervisor.
- Adhere to company HIPAA policies and procedures. Identify, maintain and protect sensitive HIPAA information (PHI) and following procedures to ensure the security of such information.

**Benefits**:

- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance

Weekly day range:

- Monday to Friday
- No weekends

**Education**:

- High school or equivalent (required)

**Experience**:

- Insurance verification: 3 years (required)
- Intake Specialist: 1 year (required)

Ability to Commute:

- Houston, Tx 77054 (required)

Ability to Relocate:

- Houston, Tx 77054: Relocate before starting work (required)

Work Location: In person

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