Insurance Authorization Specialist

Insurance Authorization Specialist

Description of Responsibilities
The Insurance Authorization Specialist is responsible for the referral process. They oversee the benefit investigations process working with both patients and referral sources. Insurance Authorization Specialists facilitate documentation and insurance requirements for the successful authorization and administration of product(s) and service(s). They collaborate with the Revenue Cycle team assisting with billing issues related to the intake process.
Responsibilities of the Patient Intake Coordinator include the following:

Facilitates all aspects of the benefit investigation process which encompasses insurance verifications, prior authorizations and documentation of all necessary administrative and clinical data;

Coordinates and educates referral sources with regards to payor coverage and prerequisites to expedite the patient treatment timeline;

Ensures each patient case is continuously evaluated and assists with any gaps identified during the intake process to ensure an excellent patient experience and accurate billing processes;

Assist patients during the benefit investigation process to educate and maximize the patient experience at BrookWell Infusion;

Work with all third party vendors, including efficient and timely correspondence, ensuring correct information is provided to establish and maintain accurate and efficient billing practices

Coordinates with all departments as needed during the intake process;

Manage intake claims through various systems, i.e. Docutrack, Weinfuse, etc..

Participates in the development and implementation of operating policies and procedures;

Ensures all activities of the patient care department are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State and payor regulations, guidelines and requirements;

Understands and remains current with all insurance prerequisite requirements, keeping up with all carrier rule changes and communicating that information to all clinics;

Assists in training other intake coordinator staff as needed motivating each other to achieve peak productivity and performance;

Identifies opportunities to improve internal efficiencies and revenue opportunities across all clinics;

Assists other departments in maintaining a patient-centered facility

Assists with audits and quality assurance functions.

Reports to the partners or their designee in a prompt, efficient manner with the proper disposition. This may include participation in routine management meetings, training oversight, report preparation, and coordination with other departments or personnel.

Other projects, activities, or responsibilities assigned at the discretion of the partners, their designee or supervisor.

Minimum Qualifications

Must possess a bachelor's degree or equivalent experience

Computer literacy, including knowledge of software applications and familiarity with MS Office, electronic health records, internet, and mobile applications

A friendly personality with good people skills including team collaboration

Exhibits attention to detail and critical thinking problem solving

Excellent written communication skills

Physical Requirements
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions in this job description:

The employee is regularly required to stand, walk, and sit, as well as talk and hear.

Good hand-eye coordination and the ability to lift up to at least 25 pounds.

Compensation details: 16-18