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Authorization Specialist
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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
- 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
- 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.
About Us
Myriad Genetics Inc., is a leading personalized medicine company dedicated to being a trusted advisor transforming patient lives worldwide with pioneering molecular diagnostics. Myriad discovers and commercializes molecular diagnostic tests that: determine the risk of developing disease, accurately diagnose disease, assess the risk of disease progression, and guide treatment decisions across six major medical specialties where molecular diagnostics can significantly improve patient care and lower healthcare costs. Myriad is focused on three strategic imperatives: maintaining leadership in an expanding hereditary cancer market, diversifying its product portfolio through the introduction of new products and increasing the revenue contribution from international markets. For more information on how Myriad is making a difference, please visit the Company's website: www.myriad.com .
We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. We are an equal opportunity employer and place a high value on diversity and inclusion at our company. In hiring and all other employment decisions, we prohibit discrimination and harassment on the basis of any protected characteristic, including race, religion, color, national origin, gender, sexual orientation, gender identity, gender expression, age, marital or veteran status, pregnancy or disability, or any other basis protected under applicable law. In accordance with applicable law, we make reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as any mental health or physical disability needs.
Please answer all questions completely. Please do not provide any information not specifically requested on this Employment Application form.
