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Authorization and Insurance Specialist

2 months ago

Salinas, California, United States American Vision Partners Full time

About American Vision Partners

At American Vision Partners, we are a leading provider of comprehensive eye care services, operating over 100 eye care centers across the United States. Our mission is to deliver exceptional patient care, pioneering research, and technology, while fostering a culture of teamwork, continuous improvement, and employee recognition.

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 an exciting opportunity to work in a fast-paced, high-volume environment and contribute to the success of our organization.

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, while maintaining 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.

Qualifications

  • 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.