Authorization Representative II

1 month ago

Vero Beach, United States Cleveland Clinic Full time

Exceptional care is a team effort. Even if you've never considered healthcare as a next step, you'll find there are many paths to creating a career at Cleveland Clinic centered on what matters most to you.We are looking to hire an Authorization Representative II to support patients' access to care by interacting with external insurance providers to comply with prior authorization requirements which are set forth by the payers. In this role you will: Confirm benefits and submit for prior authorization. Contact insurance payers for account resolutions. Contact physicians' offices for clinical information needed for peer-to-peer conversation.Our ideal future caregiver will be a quick thinker, have knowledge of healthcare terminology, insurance plans, portals and payor requirements, have experience in authorization related avenues (pre- or post-service), be technologically savvy, thrive in a team environment, be able work independently with minimal supervision, be self-motivated and pay close attention to detail.This role is a strong introduction to future growth within the department, including formal leader roles such as Work Leader, Supervisor, Manager and Senior Manager. This opportunity is also fully remote once training is completed.At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.Responsibilities:Cross trained to staff all areas of Authorization at supporting any facility with minimal leadership guidance, relays information timely while maintaining verification, pre-certification, eligibility, benefits, including copays, deductibles and out of pocket expenses.May be required to flag accounts for high dollar financial clearance.Assist with problem identification related to insurance authorizations, relays information timely.Acts as a resource for training of new team members and during the implementation of new processes.Participates on committees and engages in continuous improvement efforts.Provides physician offices and departments with accurate date and time information related to in and out patient insurance authorizations.Maintains open communication with physicians and their offices, patients and all ancillary areas in the facility.Performs some registration input in order to ensure accurate patient information for the authorization process.Identifies and utilizes appropriate reports to contact insurance payers for resolution to accounts that are pending, denied or in the appeal process.Maintains productivity and quality expectations set forth by department.Other duties as assigned.Education:High school diploma or equivalent.Languages:Certifications:None plexity of Work:Candidate must demonstrate PC skills efficiency.Ability to multitask within multiple accounts in high volume insurance verification processes.Work Experience:Minimum of 3 years of experience in a customer facing role with in person or phone contact.Minimum 1 year working with insurance payers or patient registration.An Associate's degree may substitute for up to one year of the stated experience.A Bachelor's degree my substitute for up to two years of the stated experience.Physical Requirements:Sufficient mobility and strength to move around the department and throughout the facility.Ability to stand or sit for prolonged periods of time.Excessive walking and standing while obtaining patient information when using laptop computer on wheeled device for bedside registration.Ability to lift 25 pounds.Personal Protective Equipment:Follows Standard Precautions using personal protective equipment.Pay RangeMinimum hourly: $16.47Maximum hourly: $23.61The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement.

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