Authorization and Benefits Coordinator
4 weeks ago
Job Title: Authorization and Benefits Specialist
Job Summary: We are seeking a highly skilled Authorization and Benefits Specialist to join our team at Teach Me Personnel LLC. The successful candidate will be responsible for obtaining benefits and preauthorization from payors, following up on authorization requests, and maintaining authorizations for new patients.
Key Responsibilities:
- Initiate, follow up, and secure benefits and authorizations sent to third-party payors.
- Track and follow up on all pending authorizations at 3, 7, 14, and 30 days depending on payer guidelines to expedite the claims process and avoid lost revenue.
- Process authorizations electronically, utilizing payer portals, fax, or telephone, working with payers to secure authorizations retrospectively and/or requesting single case agreements for out-of-network patients.
- Work directly with providers to secure clinical notes and other supporting documentation required to obtain authorizations timely.
- Verify authorization quantities and effective dates are returned and processed correctly by the third-party payers and loaded correctly in all systems.
- Create and maintain a centralized payer master list to record requirements by payer.
- Create a payer authorization manual and tips to securing authorization.
- Identify opportunities to improve authorization efficiencies electronically.
- Review and interpret insurance group pre-certification requirements, ensuring that proper pre-authorizations have been obtained from the payer and documented.
Qualifications:
- Education: High School Diploma or GED required; some college preferred.
- Experience: A minimum of 2 years in benefit verification and authorizations preferred.
- Skills: Communicates clearly and concisely, verbally and in writing, establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
- Ability to sustain prolonged sitting and extended computer use. Requires working under some stressful conditions to meet deadlines and to make quick decisions. Requires hand-eye coordination and manual dexterity.
Additional Information: Pay Range: $19-$21 per hour
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