Patient Authorization Specialist
2 weeks ago
Position Overview:
The Authorization Coordinator collaborates with healthcare providers, patients, ancillary departments, pharmacies, and insurance companies to ensure accurate coding of information for obtaining authorizations, thereby maximizing reimbursement opportunities.
Essential Qualifications:A minimum of an Associate's Degree along with three years of relevant experience in patient financial services or insurance (preferably within a healthcare environment) or an equivalent combination of education and experience is required. Proficiency in medical terminology, a solid understanding of medical coding, and effective written and verbal communication skills are essential. Strong problem-solving abilities and computer proficiency, including keyboarding skills, are necessary. This role demands a comprehensive understanding of ICD, CPT, and J codes to facilitate effective communication with insurance providers. The ability to foster positive relationships with patients, families, colleagues, and other stakeholders is crucial.
Desirable Qualifications:
Experience in managing ambulatory patient care administrative tasks, as well as skills in data collection and analysis, is preferred. Familiarity with record-keeping systems and interactions with external entities such as insurance companies, CMS, and billing agencies is advantageous. Knowledge of medical billing protocols and the capacity to identify potential insurance fraud or abuse is highly desirable. Experience in medication reimbursement processes, understanding physician orders, and submitting insurance claims is also beneficial. Prior experience with healthcare insurance authorization and coding, along with conducting reviews for insurance carriers and managed care, is preferred.
Work Schedule:
Monday to Friday, 8:30 AM to 5:00 PM
Note to Candidates:
This position is governed by Executive Order 161, which prohibits any State entity from requesting or mandating that applicants disclose their current or past compensation history until a conditional offer of employment has been made. If you have been asked for this information prior to that point, please reach out to the appropriate office for guidance.
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