Insurance Authorization Specialist

$49,920 - $49,920/Yr

Spa Belle Meade The Medical Spa, PLLC - Setauket- East Setauket, NY

Full-time - Mid Level

Setauket- East Setauket, NY

Amusement, Gambling, and Recreation Industries

About the position

The Authorization Specialist plays a crucial role in ensuring that patients receive the necessary out-of-network and in-network medical services by managing the authorization process. This position requires a thorough understanding of insurance, medical coding, and relevant regulations such as HIPAA. The ideal candidate will work closely with healthcare providers, insurance companies, and patients to facilitate timely approvals for procedures and treatments.

Responsibilities

• Review and process authorization requests for medical services in accordance with established guidelines.
• Communicate effectively with healthcare providers to gather necessary documentation and information for authorizations.
• Verify patient eligibility and benefits through insurance databases.
• Ensure compliance with HIPAA regulations while handling sensitive patient information.
• Utilize knowledge of medical terminology, CPT and ICD-10 coding to accurately assess authorization requests.
• Maintain accurate records of authorization requests and outcomes in the medical office system.
• Collaborate with office staff to resolve any discrepancies related to authorizations.
• Stay updated on changes in policy and procedures that may affect authorization processes.

Requirements

• Minimum of 2 years experience in a surgical office setting.
• Out of network authorization and insurance verification knowledge is required (minimum 1 year working experience).
• Familiarity with medical coding systems (CPT, ICD-10) is highly desirable.
• Proficient in medical terminology relevant to various healthcare services.
• Excellent organizational skills and attention to detail to manage multiple authorization requests efficiently.
• Strong communication skills, both verbal and written, for effective interaction with healthcare providers, patients, and staff.
• Ability to work independently as well as part of a team in a fast-paced environment.

Nice-to-haves

• Experience working for an out of network provider as either a surgical coordinator or authorization specialist.
• Ability to speak any other language.

Benefits

• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance