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Authorization Specialist

2 months ago

Salt Lake City, United States Myriad Genetics Full time

Responsibilities

  • Verifies patient insurance coverage timely utilizing phone or online resources.
  • Submit prior authorizations to insurances in timely matter via payer specific portals and vendors
  • Ensures all pertinent medical documentation is accurate and present prior to authorization submission.
  • Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval.
  • Communicates any authorization denials to the appropriate staff.
  • Handles any discrepancies, errors, or omissions of authorization denials and files appeals when necessary for overturn of adverse decision.
  • Participates in educational activities and attends regular staff and department meetings.
  • Exhibit and manage excellent turn-around time in order to ensure timely authorizations.
  • Consistently work in a positive and cooperative manner with fellow team members and management.
  • Demonstrate flexibility to perform duties wherever volume deems it necessary.
  • Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.
  • Document activities appropriately in process notes.
  • Participates in the Quality Assurance plan.
  • Complies with applicable CLIA and HIPAA regulations.
  • Stay up to date with SOPS
  • Complies with all company and department policies and procedures
  • Contributes to a positive work and team culture

Qualifications

  • 3-5 years of experience working in medical billing, health insurance or collections with demonstrated results.
  • Insurance billing experience is preferred.
  • Good problem solving and decision-making skills.
  • Excellent customer service and phone skills.
  • Excellent time management, organizational, communication, multitasking and teamwork skills.
  • Working knowledge of ICD-10, CPT and HCPCS coding (preferred but no required).
  • Ability to successfully navigate between multiple systems throughout the course of the workday this includes but is not limited to billing software, written Standard Operating Procedures and payer portals.
  • Preferred authorization experience

Physical & Lifting Requirements

  • Lifting Requirements - light work or exerting up to 20 pounds of force frequently.
  • Physical Requirements - stationary positioning, moving, operating, ascending/descending, communicating and observing.
  • Use of equipment and tools necessary to perform essential job functions.

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