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Authorization Specialist

2 months ago

Dallas, Texas, United States Vital Care Infusion Services Full time
Job Summary:

As a key member of our team at Vital Care Infusion Services, you will play a critical role in ensuring timely and accurate authorizations for our patients. Your attention to detail and ability to work efficiently will be essential in reducing denial rates, DSO, and bad debt. You will work closely with our franchise partners, payers, and internal departments to ensure seamless communication and resolution of authorization issues.

Key Responsibilities:
  • Review patient files for completeness and accuracy, ensuring all revenue opportunities are captured and prior authorizations are submitted in a timely manner.
  • Communicate effectively with stakeholders regarding authorization status and progress.
  • Document case activity, communications, and correspondence in our computer system to ensure accuracy and completeness of account activity.
  • Investigate and verify benefits for pharmacy and medical third-party claims.
  • Obtain reauthorizations, initiate requests, and track progress to ensure timely responses from insurance carriers and other payers.
  • Track, report, and escalate service issues arising from requests for authorizations or other issues that delay service.
  • Communicate financial obligation information with patients to ensure they understand all therapy costs before starting service.
Requirements:
  • Excellent communication skills, including listening, speaking, understanding, and writing English.
  • Proven understanding of processes, systems, and techniques to ensure successful billing and collection efforts.
  • Ability to identify gaps and problems from documentation reviews and determine lasting solutions.
  • Strong organizational skills with the ability to track and maintain clear, complete records of activities and cases.
  • Proven knowledge and skill in utilizing the MS Office suite of software and pharmacy applications.
Education and Experience:
  • 2 years' experience in intake/authorizations is required.
  • 2 years' minimum in-home infusion therapy experience is required.
  • High School Diploma or equivalent.
Vital Care Infusion Services is an Equal Opportunity Employer.