Authorization specialist

Here's a professional Authorization Specialist job description that includes experience with eClinicalWorks (eCW):

Job Title: Authorization Specialist

Location:Drg pain and Orthopedics
Department: Revenue Cycle / Front Office / Medical Billing
Reports To: Billing Supervisor / Practice Manager

Job Summary:

We are seeking a detail-oriented and efficient Authorization Specialist with hands-on experience in eClinicalWorks (eCW). The Authorization Specialist is responsible for verifying insurance coverage, obtaining prior authorizations for procedures, imaging, referrals, and medications, and ensuring all required documentation is accurately entered into the eCW system. This role plays a vital part in optimizing patient access to care while ensuring compliance with payer guidelines.

Key Responsibilities:

• Request and obtain prior authorizations for procedures, diagnostic tests, specialist referrals, and medications using payer portals and telephone communication
  
• Utilize eClinicalWorks (eCW) to input, track, and monitor all authorization-related activities and documentation
  
Review patient charts and physician orders to gather required information for authorization requests

Communicate with insurance companies to follow up on pending authorizations and resolve any issues or denials

Notify clinical staff and patients of authorization approvals, denials, or additional information needed

Ensure timely submission of all authorization requests to avoid appointment delays or claim denials

Maintain up-to-date knowledge of insurance guidelines, payer policies, and authorization requirements

Collaborate with scheduling, billing, and clinical teams to ensure a smooth patient experience

Accurately document all communication and status updates in eCW and maintain detailed authorization logs

Respond to inquiries from patients or staff regarding insurance coverage and authorization status

Perform insurance eligibility checks and benefit verifications when needed

Qualifications:

High School Diploma or equivalent required; Associate’s degree preferred

• Minimum 2 years of experience in medical authorization or insurance verification
  
• Proficient in eClinicalWorks (eCW) or similar EHR systems
  
Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance processes

Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans

Exceptional attention to detail and organizational skills

Ability to handle confidential information in accordance with HIPAA guidelines

Strong communication skills (both verbal and written)

Bilingual (English/Spanish) is a plus

Work Schedule:

Full-time, Monday – Friday, 8-4

Compensation:

[Include salary range or indicate “commensurate with experience” and mention any benefits like PTO, health insurance, etc.]

Let me know if you'd like this tailored to a specific medical specialty (e.g., cardiology, orthopedics, imaging center), or rewritten in resume or job ad format.