Houston Methodist - Houston, TX

posted 19 days ago

Full-time - Mid Level
Houston, TX
Nursing and Residential Care Facilities

About the position

The Senior Insurance Authorization Specialist at Houston Methodist is responsible for obtaining and managing insurance authorizations for medical services, complex procedures, and treatments. This role requires effective communication with patients, co-workers, insurance companies, and healthcare providers to ensure timely and accurate authorization of services. The specialist will also maintain records of authorization requests and collaborate with stakeholders to streamline the authorization process.

Responsibilities

  • Obtain and manage insurance authorizations for medical services and complex procedures.
  • Serve as a liaison between patients, facilities, physicians, and departments to ensure timely authorization.
  • Collaborate with internal and external stakeholders to address challenges in the authorization process.
  • Provide updates on authorization status to relevant parties.
  • Maintain accurate records of all authorization requests and approvals.
  • Document communication with insurance providers and healthcare professionals.
  • Gather necessary documentation for insurance authorization requests from healthcare providers.
  • Respond promptly to requests regarding authorization status.

Requirements

  • High School diploma or equivalent education.
  • Three years of experience working with insurance authorization, preferably in a physician office setting.
  • Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies.
  • Ability to manage multiple tasks in a fast-paced environment.
  • Mid-level medical terminology and knowledge of insurance requirements for physician visits and procedures.

Nice-to-haves

  • Working knowledge of CPT and ICD-10 coding conventions.
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