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Authorization Specialist
2 months ago
The Authorization Specialist plays a crucial role in ensuring that all information is accurately coded to obtain authorizations for maximum reimbursements. This involves working closely with providers, patients, ancillary departments, pharmacy, and insurance carriers to ensure seamless communication and efficient processing.
Key Responsibilities:- Collaborate with healthcare teams to gather and verify patient information, medical records, and insurance details.
- Utilize medical coding knowledge to accurately assign ICD, CPT, and J codes for optimal reimbursement.
- Communicate effectively with insurance carriers to resolve authorization issues and negotiate reimbursement.
- Maintain accurate and up-to-date records of patient information, insurance details, and authorization status.
- Stay up-to-date with changing medical coding guidelines, insurance regulations, and industry best practices.
- Associate's degree in a related field and three years of relevant experience in patient financial services or equivalent combination of education and experience.
- Working knowledge of medical terminology, medical coding, and written/oral communication skills.
- Excellent problem-solving skills, computer, and keyboarding skills.
- Strong knowledge of ICD, CPT, and J codes.
- Prior experience working with ambulatory patient care administrative functions, collecting/analyzing data, and organizing record-keeping systems.
- Knowledge of medical billing requirements and ability to recognize insurance fraud/abuse.
- Experience with medication reimbursement, physician orders, and insurance claim submission.
This role requires a flexible schedule, working Monday through Friday with varying hours.
What We Offer:Upstate University Hospital is committed to providing a supportive and inclusive work environment. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth and development.
