Insurance Authorization Specialist
4 weeks ago
Job Summary
As a key member of our team at Advocate Aurora Continuing Health, the Insurance Authorization Representative plays a vital role in ensuring seamless patient care. This position is responsible for maintaining, confirming, and securing referrals, authorizations, or pre-certifications required for patients to receive physician or medical services.
Key Responsibilities
- Verify the accuracy and completeness of patient account information
- Maintain a database of payer authorization requirements
- Contact insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients
- Collaborate with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations
- Educate patients, staff, and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends
Requirements
- Typically requires 1 year of experience in providing customer service that includes experiences in patient accounts, third-party payer plans, accounts receivable/collection processes, and medical clinic processes and workflow
- Knowledge of third-party payers and pre-authorization requirements
- Understanding of basic human anatomy, medical terminology, and procedures for application in the patient referral/pre-certification/authorization processes
Working at Advocate Aurora Continuing Health
We are committed to providing high-quality patient care and excellent customer service. As an Insurance Authorization Representative, you will have the opportunity to work in a dynamic and supportive environment, collaborating with a team of professionals who share your passion for delivering exceptional patient care.
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