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About the position
The Insurance Authorization Specialist plays a crucial role in ensuring the timely and accurate authorization of medical procedures, treatments, and services. This position requires close coordination with healthcare providers, insurance companies, and patients to verify coverage and secure necessary approvals, ultimately optimizing reimbursement and enhancing patient satisfaction. The ideal candidate will have strong communication skills, attention to detail, and a solid understanding of healthcare insurance processes.
Responsibilities
- Obtain prior authorizations for medical procedures, treatments, and services by contacting insurance companies and verifying coverage details.
- Accurately enter and update authorization information into the electronic medical record (EMR) system.
- Monitor authorization status and follow up with insurance companies as needed to ensure timely approvals.
- Inform patients of authorization status, coverage details, and any potential out-of-pocket expenses.
- Work closely with physicians, nurses, and other healthcare providers to gather necessary documentation for authorization requests.
- Collaborate with the Central Billing Office (CBO) to ensure accurate and complete submission of claims.
- Assist billing department with preparation of billing data and medical claim submission to insurance companies.
- Address and resolve any issues or discrepancies related to insurance authorizations.
- Appeal denied authorizations by preparing and submitting appropriate documentation.
- Maintain knowledge of insurance policies, procedures, and regulatory requirements.
- Ensure compliance with all HIPAA regulations and maintain patient confidentiality at all times.
Requirements
- High School Diploma or equivalent
- Minimum of 2 years' experience in medical billing, insurance verification, or authorization processes.
- Understanding of healthcare insurance plans, medical terminology, HIPAA regulations, and medical recordkeeping best practices.
- Proficiency in EMR software and basic computer applications (e.g. Microsoft Office)
- Strong organizational skills and attention to detail.
- Excellent communication and interpersonal skills.
- Ability to maintain effective and organized systems to ensure timely patient flow.
- Problem-solving abilities and a proactive approach to tasks.
Benefits
- Competitive salary commensurate with experience.
- Comprehensive benefits package including health insurance, retirement plan, paid time off and paid holidays.
- Professional development opportunities.
- Positive and collaborative work environment.
