What are the responsibilities and job description for the Insurance Authorization Specialist position at Syracuse Prosthetic Center?
Job Summary
We are seeking a highly motivated and detail-oriented Insurance Authorization Specialist to join our dynamic team. In this role, you will be responsible for managing the prior authorization process to ensure timely approval of prosthetic and orthotic services and perform patient checkout procedures. This entails use of EMR system and insurance portals to obtain and track authorizations as well as patient scheduling and collection of payments. Your expertise will help streamline patient care, facilitate effective communication with insurance providers and referral sources. If you thrive in a fast-paced environment and possess a passion for improving patient outcomes through efficient authorization management, this is the perfect opportunity for you!
Responsibilities
- Review and analyze medical documentation to determine the necessity of services based on insurance guidelines and policies.
- Submit prior authorization requests to insurance companies accurately and promptly, ensuring all required information is included.
- Follow up with insurance carriers to track approval status, resolve any issues, and expedite processing times.
- Must be proficient with authorization processes for various insurance companies excellent computer skills, self-motivated and results-oriented.
- Communicate effectively with healthcare providers, patients, and insurance representatives to gather information, authorization requirements or clarify requests as needed.
- Maintain detailed records of all authorization requests, approvals, denials, and related correspondence in compliance with HIPAA regulations.
- Verify patient insurance coverage and eligibility prior to submitting authorization requests.
- Stay updated on all types of insurance policies, including HCPCS codes and ICD-10 codes and other coding standards relevant to DME billing and documentation.
- Collaborate with medical office staff to ensure accurate documentation of medical records and coding information for prosthetic and orthotic services.
- Ensure compliance with all federal and state healthcare regulations related to patient privacy and data security.
Skills
- Strong knowledge of insurance plans and processes, insurance verification and coverage procedures.
- Experience working in a medical office environment ; familiarity with office workflows is required.
- Proficiency in medical terminology, medical records management, and insurance authorizations
- Excellent computer skills, self-motivated and results-oriented.
- Excellent understanding of HIPAA regulations to safeguard patient information at all times.
- Ability to interpret insurance policies and manage complex authorization workflows efficiently.
- Strong organizational skills with keen attention to detail for accurate record keeping.
- Effective communication skills for liaising with healthcare providers, insurance companies, patients, and team members.
- Experience with office software applications such as electronic medical records systems or practice management software.
- Prior medical office experience is required; relevant experience in supportive patient services and administrative role.
Pay: From $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
Work Location: In person
Salary : $22