Authorization/Billing Specialist
6 days ago
Responsibilities: Authorization/Billing Specialist
- Research, follow-up, and resolve all open/pending Authorizations in a timely manner
- Contact Payers for status of outstanding/pending Authorization request
- Minimum requirements of 35-45 Authorization submissions and or follow ups daily
- Verifies patient insurance eligibility and benefits by means of Internet resources or manually procuring information from the insurance carrier
- Conveys information regarding procedure codes and diagnostic codes in order to receive correct referrals for office visits and authorization for inpatient
- Communicates and coordinates with interdepartmental and interoffice personnel to procure correct and detailed information regarding all referrals and authorizations
- Updates and informs all parties involved of any insurance or procedural changes regarding authorizations or office visit referrals
- Obtains all referrals and authorizations for office visits and procedures
- Identify primary and, as applicable, additional payers, based on established payer coverage guidelines and criteria
- Responsible for verifying medical authorizations for services in accordance with established policies and procedures
- Analyze medical documentation and process authorizations for services, supplies, and medications
- Maintain accurate documentation of authorizations and other related records
- Verify insurance benefits, obtain authorization numbers, and ensure authorization criteria is met
- Communicate with insurance providers, healthcare providers, and other members of the healthcare team
- Assist with customer service inquiries related to authorizations
- Maintain knowledge of changes in insurance policies and procedures
Qualifications:
- Must be able to work in a fast pace environment in which information is constantly changing
- Excellent customer service, communication and interpersonal skills
- Proficiency in computer skills and data entry
- Ability to work independently and manage time effectively
- Ability to maintain a high degree of confidentiality of patient information and able to discuss eligibility, benefits and finances with patient
- Knowledge of medical terminology and insurance guidelines
Job Type: Full-time
Pay: $ $19.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Medical billing: 1 year (Required)
Work Location: In person
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