Authorization Specialist

4 weeks ago


Pittsfield, Massachusetts, United States Berkshire Health Systems Full time

Job Summary:

The Authorization Specialist will be responsible for selected fiscal aspects of accounts to prepare for billing, ensuring maximum payment on a timely basis and maintaining accurate history files. This role requires daily review of scheduled patients to guarantee a solid source of reimbursement is in place. The Authorization Specialist will also be responsible for inquiries and responses to the appeals process, as well as all inquiries from patients, families, professional and institutional providers, inter and intra department staff, government and third-party payers, case management companies, patient accounting, clinical department staff, and case managers until the time of billing. As a patient advocate, the Authorization Specialist will inform patients with self-pay liabilities of hospital collection policy and refer them to the Advocacy for Access Office.

Key Responsibilities:

  • Review and prepare accounts for billing to ensure maximum payment on a timely basis.
  • Conduct daily review of scheduled patients to guarantee a solid source of reimbursement is in place.
  • Respond to inquiries and appeals from patients, families, and other stakeholders.
  • Act as a patient advocate and inform patients of hospital collection policy.
  • Collaborate with internal and external stakeholders to ensure accurate and timely billing and reimbursement.

Requirements:

  • Three years of experience in a hospital admitting/billing office and/or equivalent knowledge of major third-party payors.
  • Two years of college (business/health-related) or equivalent work experience.
  • Medical terminology preferred.
  • Strong typing ability (40 wpm) and computer skills.
  • Professional presentation with exceptional customer service skills.
  • Ability to speak the English language in a clearly understandable manner.
  • Proven ability to interact appropriately with hospital staff and physicians.
  • Ability to consistently maintain high levels of confidentiality.
  • Ability to handle stressful situations calmly and rationally.

About Berkshire Health Systems:

Berkshire Health Systems is a leading healthcare provider in the region, dedicated to delivering high-quality patient care and exceptional service. We are committed to fostering a collaborative and supportive work environment that promotes professional growth and development.



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