Multi Office Medical Clinic is searching for an experienced candidate for the position of Revenue Cycle Management - Authorizations Specialist. If you are looking for a full time position please look at the qualifications below. Position can be remote after required in office training if preferred.
The essential functions include, but are not limited to the following:
- Must be available from the hours of 8 am-5 pm CT Monday – Friday
- Manage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriate
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
- Review accuracy and completeness of information requested and ensure that all supporting documents are present
- Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial
- Receive requests for prior authorizations through the electronic health record (EHR) and/or via phone or fax and ensure that they are properly and closely monitored
- Using knowledge of required authorizations, maintain tracker of all procedures requiring auth and pertinent details
- Ability to use portals to verify active insurance and coverage types, determining patient responsibility and OOP
- Follow up on missing or inaccurate information including coordination with clinical staff and physicians as well as all referrals to ensure no care gaps
- Ensure authorizations are available prior to patient appointments and in patient chart
- Ability to maintain good relationships with patients, providers and coworkers
- Communicate patient’s financial obligations if applicable
- Update demographic information as necessary
- Informs appropriate staff/patient of authorizations/referral requirements
- Staying current with insurance requirements, maintaining trackers with denied claims and problem solving as applicable
- Comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment
- Ability to work hand in hand with 3rd party RCM company
