Authorizations Representative

Job Overview:

The Authorization representative is responsible for the processing of all authorizations and communication with providers in regards to authorizations. This includes sending all authorizations in a timely manner and following up with providers to confirm that necessary authorization has been provided. It involves modifying and updating authorizations as need. The primary aim is to provide the providers with the authorizations needed in order to render services and bill properly. Authorization Rep will carry out any and all types of non-clinical authorization changes requested by Care Manager, and communicate the changes with the provider.

Essential Responsibilities:

• Primary contact for providers for any authorization requests
• Responsible for updating the renewal authorizations as per the clinical reviewer’s instructions
• Responsible for sending out all renewed authorizations prior to beginning of month
• Responsible for sending out all authorizations for new members prior to enrollment date
• Responsible for non-clinical changes in member’s authorizations
• Timely and thorough documentation in members’ charts in regards to authorization changes or requests
• Other duties as identified as a necessary part of employee’s role

Specific Knowledge, Skills, and Abilities:

• Proficient in the use of office equipment and the computer; Microsoft Word and Excel.
• Self-directing, good organizational and interpersonal skills.
• Word Processing/Spread Sheets, Data Entry