Authorization Specialist

4 days ago

Orange, California, United States Alex Zand MD A Professional Corporation Full time

The Authorization Specialist plays a critical role in our team, acting as the liaison between our patients, providers, and specialist services.

Your primary responsibility will be to manage and facilitate patient referrals, confirming insurance coverage, obtaining authorizations, and ensuring a smooth and efficient process for both patients and providers. This role requires a detail-oriented individual with a strong background in healthcare coordination.

Responsibilities:

  • Strong knowledge of insurance: Verify insurance eligibility and benefit coverage
  • Submit referral requests: Obtain authorization for specialist consults, diagnostic studies, home health services, physical therapy, and other services. About 60-80 requests to be submitted on a daily basis.
  • Routine status checks: Monitor the status of pending submissions and follow up on any issues that may arise accordingly.
  • Customer service: Serve as the primary point of contact for patients, specialists, and healthcare providers, ensuring clear communication and coordination throughout the referral process.
  • Record keeping: Maintain accurate and up-to-date records of all referrals, authorizations, and patient communications in the electronic health record (EHR) system.
  • Troubleshooting: Understand that complicated situations may arise and be ready and willing to directly address problems with a sense of urgency.

Requirements:

  • 6 months- 1 year of prior experience in a referral coordinator within a healthcare setting
  • Proficiency in insurance (PPO vs. HMO vs. Medicare vs. W/C), authorizations, and an understanding of healthcare processes
  • Excellent organizational and multitasking skills
  • Strong communication and customer service skills
  • Ability to interact effectively with patients, providers, and insurance representatives.
  • Proficiency in using an EHR system (eClinicalWorks preferred)

Job Type: Full-time

Pay: From $22.00 per hour

Expected hours: 35 – 40 per week

Benefits:

  • Dental insurance
  • Health insurance

Application Question(s):

  • What is your expectation with pay (hourly rate)?
  • Do you speak any other languages?

Experience:

  • clinical: 1 year (Required)

Work Location: In person

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