Authorization Specialist I

2 days ago


Morristown, Tennessee, United States Atlantic Health System Full time
Job Summary

The Authorization Specialist I plays a critical role in securing medical authorizations from third-party payers for post-acute services. This position is responsible for obtaining written documentation, tracking, prioritizing, and reporting outcomes of each authorization request.

Key Responsibilities
  • Completes full financial clearance of upcoming scheduled visits, including insurance verification, pre-registration, and 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, operating within Epic Workqueues to stay up to date with all upcoming visits requiring this review.
  • 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.
Requirements
  • 0-3 years of prior experience
  • HS Diploma or equivalent
  • All legally/reasonably expected certifications needed for function and level
Preferred Qualifications
  • Bachelors Degree or equivalent combination of education/experience
  • Applicable experience as Patient Access Representative or Authorization Specialist


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