4 Authorization Specialist Jobs in Princeton, NJ
Lingraphica is Hiring an Authorization Specialist Near Princeton, NJ
: The Authorization Specialist’s main function is to secure funding approvals for our customers whether it be from private insurances, State funding, Medicare, or any other type of funding source. This position serves as the liaison between many other teams and provides excellent customer service to employees as well as customers using their knowledge of how insurance verifications, medical policies, and insurance requirements/guidelines work. The Authorization Specialist is also responsible for maintaining accurate records of policies and insurances for employees to view and reference as needed.
**Essential Duties & Responsibilities: **
Initiates prior authorizations, pre-determinations, and out-of-network gap exceptions.
Initiates and follows through with authorization appeals.
Follows up on all authorization requests in a timely manner and reports on progress to internal teams.
Applies to and follows up on applications for funding through Government programs.
Negotiates and obtains agreements with insurance companies for individual cases when necessary.
Communicates internally and externally regarding authorizations, appeals, and exceptions.
Assists in eligibility and benefits inquiries when necessary.
Determines the authorization requirements of each health plan and keeps detailed records of the medical policies and requirements.
Maintains accurate and complete documentation of all inquiries.
Proactively communicates with team members regarding identified potential issues and concerns.
Tracks patterns and trends of authorization issues from payers to eliminate future delays in authorization processing.
Exhibits strong problem-solving skills through both verbal and written communications.
Assists reimbursement team in authorization related corrections on rejected or denied claims.
Answers in-bound calls and assists customers.
Exercises the above with discretion and independent judgement.
Performs other duties and works on special projects related to authorization.
Qualifications:Qualifications
**Knowledge, Skills & Abilities **
Experience with prior authorizations, pre-determinations, and out-of-network gap exceptions.
Proficient understanding of healthcare provider environment.
Excellent problem-solving skills and attention to detail.
Excellent customer service skills and professionalism.
Ability to comfortably interface with various users across the organization.
Proficiency with MS Outlook, Word, Excel, Adobe.
Knowledge of insurance requirements regarding face-to-face documentation.
**Education & Experience **
Bachelor’s Degree or equivalent combination of education and experience
Familiarity with entire revenue cycle and terminology.
Experience with insurance portals such as NaviNet and Availity.
Experience with DME/Home Medical Equipment.
Experience with healthcare claims (e.g. authorization, billing, collections).
Additional Information
Travel RequirementsTravel required for the annual company meeting and team off-site, within the continental United States, approximately twice per year.
**Work Environment & Physical Demands: **
Incumbent works from home and is expected to maintain a safe, productive work environment with secure internet access. Must be able to operate a computer with or without a reasonable accommodation.
AccommodationsTo perform this job successfully, an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge, skills, and/or ability abilities and physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
To learn more about Lingraphica, visit:www.lingraphica.com!
This Organization Participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.
Este empleador participa en E-Verify y proporcionará al gobierno federal la información de su Formulario I-9 para confirmar que usted está autorizado para trabajar en los EE. UU.
Job Summary
Full Time
Wholesale
$95k-116k (estimate)
05/22/2023
07/08/2024
aphasia.com
PRINCETON, NJ
25 - 50
1990
Private
ANDREW GOMERY
$5M - $10M
Wholesale
Related Companies
The job skills required for Authorization Specialist include Customer Service, Problem Solving, Prior Authorization, 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.
Similar Jobs
Popular Articles
