Authorization and Insurance Specialist
3 weeks ago
About American Vision Partners
At American Vision Partners, we are a leading provider of comprehensive eye care services, partnering with top ophthalmology practices to deliver exceptional patient care. Our mission is to build the nation's largest and most comprehensive eye care practices, operating over 100 eye care centers across the country.
Job Summary
We are seeking an experienced Authorization Specialist to join our team. As an Authorization Specialist, you will play a critical role in verifying insurance coverage, benefits, and obtaining prior authorization for services. This is a dynamic and challenging role that requires strong communication and organizational skills.
Key Responsibilities
- Insurance Verification: Contact insurance plans to determine eligibility, obtain coverage, benefit information, and prior authorization for services.
- Prior Authorization Processing: Process requests for prior authorization from clinics and Patient Care Coordinators.
- Documentation: Document findings thoroughly and accurately.
- Demographic Updates: Make changes to demographic information as necessary to produce a clean patient statement.
- Productivity and Quality: Meet or exceed productivity standards in the completion of daily assignments and accurate production. Maintain an error rate in accordance with departmental policy.
- Training and Development: Perform training with organizational staff on procedures for requesting, documenting, and processing prior authorizations.
- Additional Duties: Perform additional duties as assigned.
Requirements
- Education: High School Diploma or GED.
- Experience: 2+ years of experience in a medical billing environment.
- Ophthalmology Background: Ophthalmology background is a plus.
- Knowledge and Skills: Active knowledge of CMS guidelines, contracted insurance guidelines, and coding policies. Demonstrated computer and math skills. Detail-oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment. Excellent verbal and written communication skills. Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism.
Benefits and Perks
We offer a comprehensive benefits package, including medical and dental insurance, significant eye care discounts, PTO, and opportunities for growth and development.
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