Top 89 Authorization specialist Jobs in Alpharetta, Ga

Case Management Authorization. Specialist IP
Emory Healthcare —Decatur, GA
- $24.12 - $29.39 an hour
- Part-time
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
- Wellness program
- Health insurance
3d
Case Management Authorization. Spec IP
Emory Healthcare —Atlanta, GA
- $24.12 - $29.39 an hour
- Part-time
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
- Wellness program
- Health insurance
Surgery Prior Authorization Specialist
PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC —Atlanta, GA
- Full-time
- Surgery
- HIPAA
- Mid-level
Quick Apply
Associate Claims Analyst - MNA Claims Triage
Markel Service Inc. —Alpharetta, GA
- $25.11 - $34.52 an hour
- Weekends as needed
- Hybrid work
- Microsoft Outlook
- Customer service
- Word processing
- AD&D insurance
- Employee stock purchase plan
Quick Apply
6d
Patient Access Priority Engagement Specialist Lead
Emory Healthcare —Atlanta, GA
- $22.97 - $27.99 an hour
- Weekends as needed
- Mid-level
- Bachelor's degree
- Continuous improvement
- Wellness program
- Health insurance
Full Time Prior Authorization Specialist (IV and Injectables)
Arthritis & Rheumatology Center PC —Woodstock, GA
- Full-time
- High school diploma or GED
- In-person
- Entry level
- Paid holidays
- Disability insurance
Quick Apply
1d
Customer Support Coordinator - Product Selection I
Siemens —Peachtree Corners, GA
- $34,986 - $59,976 a year
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- US work authorization
7d
Prior Authorization Specialist
Marietta Rheumatology Associates, PC —Marietta, GA
- $16 - $18 an hour
- Part-time
- In-person
- 1 year
- Entry level
- Flexible schedule
Quick Apply
3d
Financial Clearance Specialist
Shepherd Center, Inc. —Atlanta, GA
- Full-time
- Hospital
- Basic math
- Inpatient
Quick Apply
Registration Associate
Children's Healthcare of Atlanta —Alpharetta, GA
- Weekends as needed
- Microsoft Word
- Basic math
- Office
- On-the-job training
Quick Apply
Insurance Verification Specialist - Procedure Scheduling Experience Preferred
Atlanta Interventional Institute —Smyrna, GA
- Urgently hiring
- Mid-level
- Communication skills
- Under 1 year
- Paid holidays
- Health insurance
Quick Apply
ABA Billing Specialist
Atlanta Autism Center —Atlanta, GA
- $50,000 - $60,000 a year
- Management
- Medical office experience
- HIPAA
Quick Apply
Prior Authorization Pharmacist
Curant Health —Smyrna, GA
- $125,000 a year
- Full-time
- Hybrid work
- Mid-level
- Team management
- 2 years
- Paid parental leave
- Paid holidays
Quick Apply
3d
Pre-Certification Specialist Lead
United Musculoskeletal Partners —Atlanta, GA
- Weekends as needed
- Heavy lifting
- HIPAA
- Mid-level
Quick Apply
Customer Experience Specialist
Oldcastle Infrastructure —Atlanta, GA
- Hybrid work
- Office
- Manufacturing
- 2 years
- Health insurance
- Dental insurance
Quick Apply
3d
Utilization Review Specialist
Positive Impact Health Centers INC —Decatur, GA
- Full-time
- LMFT
- Psychiatry
- RN License
2d
Lead Registration Associate
Children's Healthcare of Atlanta —Sandy Springs, GA
- Full-time
- Microsoft Word
- Basic math
- Mid-level
- On-the-job training
Quick Apply
7d
Insurance Verifier
Proco LLC —Marietta, GA
- Extended hours
- Microsoft Outlook
- Medical office experience
- Mid-level
Quick Apply
Medical Records Specialist
PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC —Atlanta, GA
- Full-time
- Spanish
- Computer literacy
- HIPAA
- Profit sharing
- Health insurance
Quick Apply
Customer Solutions Specialist
Diversitech —Duluth, GA
- Overtime
- Spanish
- 5 years
- Research
2d

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authorization specialist jobs near alpharetta, ga

Case Management Authorization. Specialist IP

Emory Healthcare -
Decatur, GA

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Job Details

Part-time
$24.12 - $29.39 an hour
3 days ago

Benefits

Wellness program
Health insurance
Benefits from day one
Loan assistance

Qualifications

Customer communication
High school diploma or GED

Full Job Description

Overview:

Be inspired. Be valued. Belong. At Emory Healthcare

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

Comprehensive health benefits that start day 1
Student Loan Repayment Assistance & Reimbursement Programs
Family-focused benefits
Wellness incentives
Ongoing mentorship, development, leadership programs
And more

Description:

The Case Management Authorization Specialist IP (CMAS) has a general understanding of insurance requirements as it relates to insurance verification, notification, authorization and collaboration.

This role functions with minimal oversight and guidance in the Care Management Inpatient Department or Utilization Management Department with distinct responsibilities.

RESPONSIBILITIES:

Care Management Inpatient Department:

Assists the Care Management Inpatient team to timely transition patients into post-acute services within the allotted amount of reimbursable hospital days, as determined by the clinical authorization obtained.
Submits referrals for securing post-acute care services as directed, which may include Home Health, Durable Medical Equipment, Subacute Rehabilitation, Inpatient Rehabilitation Facility, Long-Term Acute Care, Hospice, or Long-Term Care.
Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital.
Ensures proper use of Care Management Systems and display adherence with workflows, which guide all responsibilities.

Utilization Management Department:

Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances based on the payer's notification requirements and UR Department processes.
Verify completion of automated NOAs for appropriate insurances, and if necessary, will resubmit manually.
Submit appropriate admission and continued stay clinical documentation supporting services or care provided to insurances without access to Emory's Electronic Health Record based on payer's preferred method and reimbursement methodology.
Secures reimbursement by confirming insurance authorization determination for the inpatient or observation admission through appropriate and required communication methods.
Will add approved bed days to Emory's Electronic Health Record as appropriate based on authorization and reconcile authorized versus actual days to secure reimbursement for provided care.
Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital.
Display adherence with department processes, which guide all responsibilities.

COMPLIANCE:

Care Management Inpatient Department:

Ensure regulatory requirements are met as it relates to the delivery of Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Medicare Change of Status Notice (MCSN), and Medicare Hospital Issued Notices of Non-Coverage (HINNs) for Medicare beneficiaries as appropriate.
Maintains all required annual competencies, metrics, and fully participate and engage in department process improvements.

Utilization Management Department:

Maintains all required annual competencies, metrics, and fully participate and engage in department process improvements.

COLLABORATION:

Care Management Inpatient Department:

Collaborates with insurance to initiate/request authorizations for post-acute care.
Provides effective and efficient proactive communication to internal and external customers.
Assists in collaborative efforts with the Utilization Management Department, Revenue Cycle, Care Management Medical Directors, and other required departments.

Utilization Management:

Follow the UR DepartmentÂ¿s peer-to-peer workflow as appropriate.
Will inform the Patient Access Department and UM leadership of any discrepancies identified related to coordination of benefits and/or coverage as it relates to ineligible coverage, non-covered services or out of network status.
Assists in collaborative efforts with the Care Management Department, Revenue Cycle, Utilization Review Medical Directors, and other required departments.

ADDITIONAL RESPONSIBILITIES:

Ability to multi-task in a fast-paced environment while efficiently handling multiple priorities and ensuring deadlines are met.
May specialize in certain payors but overall is an insurance generalist within the department.
Assists with providing technical and clerical support, as directed.
Performs other duties and tasks as assigned.

TRAVEL:

Less than 10% of the time may be required.

WORK TYPE:

Care Management IP Department: On-site.
Utilization Management Department: This position is a remote position outside traditional office, often from home or another remote setting.

MINIMUM QUALIFICATIONS:

Education - High School diploma or equivalent.
Experience - At least two years of experience in a healthcare setting is required.

PREFERRED QUALIFICATIONS:

Education - Associate or Bachelor's degree preferred.
Experience - Two years of insurance verification, authorization, or related work preferred.

PHYSICAL REQUIREMENTS: (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste. Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, and environmental conditions may vary depending on assigned work area and work tasks.

Additional Details:

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at [email protected]. Please note that one week's advance notice is preferred.

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Refine Your Search

authorization specialist jobs in alpharetta, ga

Case Management Authorization. Specialist IP

Case Management Authorization. Spec IP

Surgery Prior Authorization Specialist

Associate Claims Analyst - MNA Claims Triage

Patient Access Priority Engagement Specialist Lead

Full Time Prior Authorization Specialist (IV and Injectables)

Customer Support Coordinator - Product Selection I

Prior Authorization Specialist

Financial Clearance Specialist

Registration Associate

Insurance Verification Specialist - Procedure Scheduling Experience Preferred

ABA Billing Specialist

Prior Authorization Pharmacist

Pre-Certification Specialist Lead

Customer Experience Specialist

Utilization Review Specialist

Lead Registration Associate

Insurance Verifier

Medical Records Specialist

Customer Solutions Specialist

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