Authorization Specialist
4 weeks ago
The Authorizations Specialist I is responsible for securing medical authorizations from third party payers (commercial and government) for post-acute services; will be instrumental in obtaining written documentation, tracking, prioritizing, and reporting outcomes of each authorization request.
Summary:
+ Completes full financial clearance of upcoming scheduled visits (insurance verification, pre-registration, authorization)
+ Submits authorization requests, including applicable clinicals, to payer authorizing services.
+ Follows-up with payer to receive a determination on authorization, escalating as necessary to ensure pre-service approval.
+ Accomplishes flexible work assignments based on daily priority, following established guidelines.
Job Duties:
+ Completes patients Facesheet with all necessary demographic / insurance information, and forms or documents in preparation for check-in or admission.
+ Coordinates with payer, referring department, and patient on obtaining a valid authorization pre-service (including submitting necessary clinicals, following up on missing information or pre-service denials, documenting approved authorizations timely, etc.).
+ Maintains and updates patients accounts for medical and financial eligibility. Required to operate within Epic Workqueues to stay up to date with all upcoming visits requiring this review (i.e., obtaining all necessary billing, insurance and other demographic information from patient or insurance representative, obtaining necessary authorizations, etc.).
+ Coordinates with patient as required to obtain any missing information or to inform the patient of the status of their accounts / amount due for service.
+ Discusses, arranges, and receives payment of bills with patient or representative, as able/requested.
Required:
+ HS Diploma or equivalent
+ All legally/reasonably expected certifications needed for function and level
Preferred:
+ Bachelors Degree or equivalent combination of education/experience
+ Applicable experience as Patient Access Representative or Authorization Specialist
+ 0-3 years of prior experience
ABOUT US
At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:
+ Morristown Medical Center, Morristown, NJ
+ Overlook Medical Center, Summit, NJ
+ Newton Medical Center, Newton, NJ
+ Chilton Medical Center, Pompton Plains, NJ
+ Hackettstown Medical Center, Hackettstown, NJ
+ Goryeb Children's Hospital, Morristown, NJ
+ CentraState Healthcare System, Freehold, NJ
+ Atlantic Home Care and Hospice
+ Atlantic Mobile Health
+ Atlantic Rehabilitation
We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
+ 100 Best Companies to Work For and FORTUNE magazine for 15 years
+ Best Places to Work in Healthcare - Modern Healthcare
+ 150 Top Places to work in Healthcare - Becker's Healthcare
+ 100 Accountable Care Organizations to Know - Becker's Hospital Review
+ Best Employers for Workers over 50 - AARP
+ Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
+ One of the 100 Best Workplaces for Millennials Great Place to Work and FORTUNE magazine
+ One of the 20 Best Workplaces in Health Care: Great Place to Work and FORTUNE magazine
+ Official Health Care Partner of the New York Jets
+ NJ Sustainable Business
EEO STATEMENT
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.
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