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JOB SUMMARY
The Authorization Specialist position is responsible for reviewing requests for prior authorization of medical services including elective and outpatient surgeries and procedures, home health, out of network requests, and expedited requests for medical necessity in accordance with government, commercial, and workers compensation health plan coverage guidelines.
This individual is responsible for benefit determination and documenting completely and accurately in accordance with healthcare system guidelines.
This position works well independently solving problems and acts as liaison with others outside the department to create smooth workflows and transitions of information needed for authorizations.
Constantly works with and maintains restricted or confidential information from many sources within the healthcare system.
Any and all duties as assigned by Manager and Director.
JOB DETAILS AND REQUIREMENTS
Type : Full Time (40 hours per 2 week pay period, without benefits)
Typical hours for this position : Varies Monday- Friday 8 : 00am-4 : 30pm
Opportunity for remote work after 6 months on-site training
Education :
High school graduate or equivalent required.
Experience :
ADDITIONAL INFORMATION
Saint Francis Healthcare System provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, or genetics.
In addition to federal law requirements, Saint Francis Healthcare System complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
In compliance with the ADA Amendments Act (ADAAA) should you have a disability and would like to request an accommodation in order to apply for a currently open position with Saint Francis Healthcare System, please call 573-331-5152 or email us at hr@sfmc.net.
Saint Francis Healthcare System supports the overall health and wellness of our colleagues by discouraging the use of tobacco and nicotine products.
If you are selected for a career opportunity with our organization, and are a tobacco or nicotine user, you will be required to complete a tobacco / nicotine cessation program within your first year of employment.
This program is free of charge as part of our Employee Assistance Program.
Last updated : 2024-06-03
Full Time
$57k-70k (estimate)
05/23/2024
06/06/2024
mediabistro.com
New York, NY
100 - 200
The job skills required for Authorization specialist include 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.