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Job Description
Department Name:
Revenue Cycle Management
Reports to:
Revenue Cycle Supervisor/Manager
GENERAL PURPOSE:
The Authorization Specialist position is responsible for providing obtaining eligibility and authorization functions. This position is also responsible for ensuring accurate data is input into EMR.
ESSENTIAL FUNCTIONS:
•Handles the verification of insurance benefits for patients
•Notifies appropriate teams of deductibles, co-insurances, and out of pockets due
•Initiate Prior Authorization requests to insurance carriers
•Receive request for prior authorizations and ensure they are properly and closely monitored
•Accurately enter required information into the EMR
•Follow up on authorization requests in a timely manner
•Regularly calls insurance companies to follow up on requests
•Attach incoming insurance information into EMR and follow established procedures for distributing information for further review by intake team
•Inform appropriate team(s) of approaching re-auth dates or expiring insurance policies
•Escalates issues to Supervisor
•Establish effective rapport with other employees within the department as well as with the clinical intake team and staff
•Recognize trends identifying issues with payer authorizations
•Provides guidance related to questions about the eligibility and authorization
•Additional duties as assigned by Supervisor
QUALIFICATIONS
•High School Education or GED
•1 years of insurance verification preferred
•Medical Office Background preferred
•Home Health or Hospice knowledge preferred
•Experience with payer provider portals preferred
•Computer proficiency – MS Office and web enabled applications strongly preferred
•Excel knowledge
•Customer Service experience preferred
ADDITIONAL REQUIREMENTS:
•Willingness to learn
•Self-motivation and the ability to work independently as well as in a team
•Provide quality customer services to internal and external teams
•Must be able to work productively in an environment with high levels of interruption; work efficiently and effectively meeting multiple deadlines and changing priorities with strong attention to detail
•Exceptional organization skills
•Maintain patient confidentiality as defined by state, federal, and company regulations
•Ability to effectively communicate with all levels of management
•Strong work ethic: results focus with a strong desire to achieve goals
•Ability to use a computer keyboard and mouse 6-8 hours a day
•Occasionally lift/carry items weighing up to 25 lbs.
•Ability to dial, answer and talk on a telephone for multiple hours a day
•Ability to handle completing a task in high levels of interruption while paying close attention to detail
•Ability to maintain confidentiality
•Ability to effectively communicate with all levels of management
•Team player
Full Time
Social & Legal Services
$47k-58k (estimate)
12/16/2023
05/14/2024
IRMO, SC
50 - 100
2010
MAXINE SUMPTER
<$5M
Social & Legal Services
The job skills required for Authorization Specialist include Confidentiality, Customer Service, Communicates Effectively, Prior Authorization, Attention to Detail, etc. Having related job skills and expertise will give you an advantage when applying to be an Authorization Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Authorization Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Authorization Specialist positions, which can be used as a reference in future career path planning. As an Authorization Specialist, it can be promoted into senior positions as a Medical Policy Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Authorization Specialist. You can explore the career advancement for an Authorization Specialist below and select your interested title to get hiring information.
If you are interested in becoming an Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Authorization Specialist job description and responsibilities
Updates patient insurance and demographics information as needed.
03/31/2022: Florence, SC
Request, follow up and secure prior-authorizations prior to services being performed.
03/30/2022: Rochester, NY
Complete authorizations and referrals for services, including appointments and procedures.
01/29/2022: Clarksville, TN
Monitors incoming patient orders and gathers information needed to complete the pre-authorization and scheduling of an order
03/22/2022: Ann Arbor, MI
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
01/29/2022: York, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Authorization Specialist jobs
There are great benefits to having a Prior Authorization Certified Specialist on staff to help with the administrative process.
03/31/2022: Greensboro, NC
Give credence to customer complaints.
02/08/2022: Salem, OR
Create a quick reference guide of your payor contacts
04/11/2022: Cincinnati, OH
Authorization Specialist assist with other clerical tasks as needed.
01/22/2022: Lincoln, NE
Licenses and certifications are not usually required to work as a prior authorization specialist.
03/09/2022: Bremerton, WA
Step 3: View the best colleges and universities for Authorization Specialist.