Seeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 15 physicians and 6 clinic locations.
DUTIES INCLUDE, BUT ARE NOT LIMITED TO:
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Interpret insurance benefits and calculate patient responsibility
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Review chart documentation to ensure patient meets medical policy guidelines
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Prioritize incoming authorization requests according to urgency
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Obtain authorizations via payer portals or by phone and follow up regularly on pending cases
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Initiate appeals for denied authorizations
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Respond to clinic questions regarding payer medical policy guidelines
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Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
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Contact patients to discuss authorization status
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Other duties as assigned
Qualifications:
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Knowledge of commercial and governmental insurance plans (HMO, PPO, EPO, etc.) and payer portals
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Knowledge of NextGen EHR software (preferred)
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MS Office, basic office support skills (telephone, filing, data entry) and basic math skills.
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Excellent telephone etiquette, pleasant personality and customer service skills.
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Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
- Plans and prioritizes to meet deadlines
EXPERIENCE: Previous experience in a similar role required.
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2 years medical prior authorization and verification experience required
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2 years' experience in a medical related field required
High school diploma or GED required
Job Type: Full-time - Monday through Friday with a few rotating Saturday mornings. Traveling involved from one clinic to another based on schedule. Dependable transportation required.
Great benefits: Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life Insurance and 401K.
Job Type: Full-time
Benefits:
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401(k)
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Dental insurance
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Health insurance
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Life insurance
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Paid time off
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Vision insurance
Medical Specialty:
Schedule:
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8 hour shift
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Day shift
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Monday to Friday
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Weekend availability
Education:
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High school or equivalent (Required)
