Insurance Authorization Specialist

2 weeks ago


Salt Lake, Utah, United States Retina Associates of Utah Full time
Job Description

Position Overview

Retina Associates of Utah (RAU) is in search of a dedicated individual to take on the role of Insurance Authorization Specialist. This position is crucial for ensuring that prior authorization and insurance verification tasks are executed efficiently, as directed by our medical professionals, to facilitate appropriate treatment for patients' conditions.

About Us

As one of Utah's leading retina-exclusive ophthalmology practices, Retina Associates of Utah is committed to Preserving the Patient's Vision. Our team consists of board-certified physicians specializing in the treatment of retinal, vitreous, and macular diseases. We pride ourselves on our surgeons' prestigious educational backgrounds and their commitment to excellence.

We adhere to all CDC and local authority guidelines to maintain the safety and well-being of our patients, staff, and community.

Key Responsibilities

  • Exercise discretion in referring patients to a Patient Accounts Specialist for financial arrangements concerning services not covered by insurance.
  • Secure authorizations from insurance providers and meticulously document notes in the practice management system promptly.
  • Employ problem-solving abilities to rectify inaccuracies in the clinic's financial records, knowing when to utilize Availity, the insurance portal, or contact the patient directly.
  • Demonstrate sound judgment when addressing unforeseen issues with patients, such as uncovered procedures or unexpected costs.
  • Consistently direct patients with outstanding balances to a Patient Accounts Specialist.
  • Provide immediate verification of benefits for urgent patient appointments.
  • Ensure timely completion of patient verification and authorization records.
  • Access patient charts as necessary, focusing solely on treatment, payment, and health operations.
  • Adhere to OSHA, HIPAA, and Compliance regulations.
  • Perform additional duties as assigned.

Qualifications

  • Comprehensive knowledge of current insurance providers and electronic portals.
  • Strong prioritization skills.
  • Exceptional communication abilities.
  • Proficiency in multiple software applications.
  • Experience handling multi-line phone systems.
  • Exhibit patience and empathy in interactions.
  • Ability to thrive in a fast-paced environment.
  • Understanding of billing procedures and collection strategies.
  • Solid grasp of accounts receivable processes, third-party payer, and CMS regulations.
  • Capability to interpret and analyze Explanation of Benefits (EOBs).
  • Experience with medical billing software.
  • Strong verbal and written communication skills.
  • Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
  • Self-motivated with the ability to work independently.
  • Reliable and consistently completes assigned tasks.


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