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Insurance Authorization Specialist
2 months ago
At Cleveland Clinic, we believe that exceptional care is a collaborative effort. Our commitment to fostering a fulfilling career path in healthcare is unwavering, and we are excited to welcome new talent to our team.
We are currently seeking an Authorization Representative who will be responsible for engaging with external insurance providers to ensure compliance with prior authorization protocols mandated by payers.
Key Responsibilities:
- Verify benefits and submit requests for prior authorization.
- Act as a pivotal contributor to process enhancement initiatives through methodologies such as Kaizen.
- Lead engagement initiatives within the department.
- Cross-train to support various areas of Authorization across multiple facilities, including verification, pre-certification, eligibility, and benefits analysis.
- Identify and utilize relevant reports to communicate with insurance payers regarding accounts that are pending, denied, or under appeal.
- Maintain productivity and quality standards as outlined by the department.
- Perform registration tasks to ensure accurate patient information for the authorization process.
- Collaborate with physician offices to gather clinical information and coordinate peer-to-peer discussions.
- Complete additional duties as assigned.
Qualifications:
- High school diploma or equivalent required.
- Minimum of 2 years of experience in a customer-facing role involving direct communication.
- Proficiency in PC skills is essential.
- Ability to manage multiple accounts in a high-volume insurance verification environment.
- An Associate's degree may substitute for up to one year of experience; a Bachelor's degree may substitute for up to two years.
Physical Requirements:
- Effective communication and information exchange capabilities.
- Ability to work in a stationary position for extended periods.
- Capability to handle physical records or operate a computer in various settings.
- Ability to lift up to 25 lbs.
Compensation:
The pay range for this position is between $15.75 and $21.65 per hour. This range reflects the anticipated compensation for new hires and may vary based on factors such as work history, experience, skill set, and education. This does not include the value of Cleveland Clinic's comprehensive benefits package, which encompasses healthcare, dental, vision, and retirement options.
