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Healthcare Billing Specialist

2 months ago

Tustin, California, United States Families Together of Orange County Full time
Job Overview

Salary: $25-30/hr

Company: Families Together of Orange County

Position: Medical Biller - Authorization Specialist

Location: On-Site

Available Positions: 1

Position Summary:

The Authorization Specialist plays a crucial role in the healthcare billing department by managing the process of obtaining prior authorizations for medical services, treatments, and medications. This position is essential for ensuring that all necessary approvals are acquired from insurance providers and other payers, facilitating the efficient delivery of healthcare services to patients.

Key Responsibilities:
  1. Evaluate and process prior authorization requests for various medical services, treatments, and medications.
  2. Ensure prompt submission of authorization requests to insurance providers and other relevant payers.
  3. Track the status of pending authorizations and conduct follow-ups as needed to secure approvals.
  4. Confirm patient insurance coverage and benefits.
  5. Assess the need for prior authorization based on the requirements of insurance plans.
  6. Maintain precise and current records of authorization requests, approvals, and denials.
  7. Document all interactions with insurance companies, healthcare providers, and patients.
  8. Address and resolve issues related to authorization denials, appeals, and peer reviews.
  9. Collaborate with healthcare providers and insurance representatives to expedite resolution processes.
Education and Qualifications:
  • High School Diploma (college education preferred).
  • Associate's or Bachelor's degree in healthcare administration, medical billing, or a related field is preferred.
Skills and Experience:
  1. A minimum of 3 years of experience in medical authorization processes.
  2. Ability to multitask effectively in a fast-paced environment.
  3. Strong computer proficiency, meticulous attention to detail, and professional communication skills.
  4. Responsiveness to the needs of both internal and external stakeholders in a courteous and professional manner.
  5. Familiarity with general EMR/EHR systems is preferred.

Families Together of Orange County is an equal opportunity employer and does not discriminate based on any protected category.