Authorization Specialist

6 days ago


Atlanta, Georgia, United States PT Solutions Physical Therapy Full time
Job Overview

The Authorization Specialist position plays a critical role in ensuring seamless prior authorization processes for patients. As a key member of our team, you will be responsible for collecting necessary documentation, communicating with clients and insurance companies, and submitting accurate and timely authorization requests.

Key Responsibilities
  • Obtain necessary information to submit authorizations for new and continued care patient needs.
  • Communicate and work effectively with colleagues from other departments to ensure efficient processing of claims.
  • Become proficient in the use of ICD-10 and CPT codes to accurately identify and submit prior authorizations.
  • Understand payor expectations for billing, reimbursement, credentialing, and audit to ensure compliance.
  • Identify and report trends and prior authorization issues relating to billing and reimbursement to improve processes.
  • Review accounts daily to meet or exceed production goals and document all account activity in a timely manner.
  • Proactively manage and maintain outstanding authorization accounts to increase billing of clean claims.
  • Research patient accounts due to invalid and/or missing authorization information and correspond with clients, insurance companies, and patients to obtain necessary information.
  • Prepare daily productivity reports and submit them to the Authorization Supervisor.
Qualifications
  • Ability to type 60 words per minute preferred.
  • Strong interpersonal, oral, and written communication skills.
  • Good organizational skills and ability to prioritize to meet deadlines.
  • Complete understanding of medical reimbursement and terminology.
  • Ability to work with disabled individuals.
  • Working knowledge of all standard office equipment.
  • Working knowledge of insurance and outpatient billing procedures.
  • High School Diploma with courses in bookkeeping and accounting or equivalent work experience in a healthcare or related setting.
  • One to two years of medical billing and administrative experience.
  • One year of supervisor experience.


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