Top 19 Authorization specialist Jobs in Frederick, Md

Referral and Authorization Specialist - Practice Support
Frederick Health —Frederick, MD
- $17.51 - $22.66 an hour
- Overtime
- Microsoft Outlook
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
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6d
Authorizations Specialist
SHERMAN KAHAN, M.D., P.A. —Frederick, MD
- $16 - $18 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Health insurance
- Dental insurance
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Medical Billing Specialist (Onsite)
Frederick Foot and Ankle Specialists, P.C. —Frederick, MD
- Full-time
- Mid-level
- High school diploma or GED
- Analysis skills
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12d
Patient Care Coordinator
Dental Arts of Frederick —Frederick, MD
- From $21 an hour
- Part-time
- Dental office
- Computer literacy
- Mid-level
- Paid training
- Health insurance
Quick Apply
7d
Billing Support Specialist I
GeneDx —Gaithersburg, MD
- $23.50 - $25.50 an hour
- Bilingual
- Writing skills
- Office
12d
Front Office Coordinator Float - Frederick, MD
Pivot Physical Therapy —Frederick, MD
- $15.00 - $23.50 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid parental leave
- Health savings account
Financial Intake Specialist - Frederick, MD Office
Optum —Frederick, MD
- $14.00 - $28.80 an hour
- Full-time
- Computer literacy
- Basic math
- Pass drug screening
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Program Administration Specialist
COMMUNITY SERVICES FOR AUTISTIC ADULTS & CHI —Montgomery Village, MD
- $58,000 - $64,000 a year
- Full-time
- Writing skills
- Mid-level
- 3 years
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7d
Full-Time Patient Relations Specialist - TRAINING PROVIDED
Frederick Foot and Ankle Specialists, P.C. —Frederick, MD
- $16 - $18 an hour
- Full-time
- Computer literacy
- High school diploma or GED
- Clinic
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12d
Registration Specialist - Plastic Surgery
BMC Berkeley Medical Center —Shepherdstown, WV
- Full-time
- Surgery
- Hospital
- High school diploma or GED
2d
Medical Assistant/Scribe
Gastroenterology Specialists of Frederick —Frederick, MD
- $18 - $21 an hour
- Overtime
- Bilingual
- Private practice
- Vital signs
- Free parking
- Paid training
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11d
Medical Assistant
US Foot & Ankle Specialists —Frederick, MD
- From $19 an hour
- Microsoft Excel
- Vital signs
- Microsoft Outlook
- Paid holidays
- Disability insurance
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PART TIME - Front Desk Receptionist - Oral Surgery
Oral & Maxillofacial Surgery Specialists, PC —Westminster, MD
- $18 - $25 an hour
- Part-time
- Dental office
- Surgery
- In-person
Quick Apply
5d
Patient Access Specialist (FT, Days)
Connections Health Solutions —Leesburg, VA
- $25 - $27 an hour
- Full-time
- Background check
- Spanish
- 11+ years
- Paid parental leave
- Health savings account
Quick Apply
4d
Front Office Coordinator - Westminster (PC), MD
Pivot Physical Therapy —Westminster, MD
- $15.00 - $23.50 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid parental leave
- Health savings account
12d
BILINGUAL MEDICAL ASSISTANT
DIGESTIVE CARE SPECIALISTS LLC —Germantown, MD
- $20 - $24 an hour
- Full-time
- Spanish
- Vital signs
- Customer service
- Profit sharing
- Health insurance
Quick Apply

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Referral and Authorization Specialist - Practice Support

Frederick Health -
Frederick, MD

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Job Details

Part-time | Full-time
$17.51 - $22.66 an hour
6 days ago

Benefits

Disability insurance
Health insurance
Dental insurance
Financial planning services
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
403(b)
Life insurance

Qualifications

Healthcare claims management
Microsoft Outlook
Overseeing health insurance pre-certification
Spreadsheets
Copy machines
Meditech
Direct client contact
HIPAA
Patient management software
High school diploma or GED
ICD-10
Insurance medical billing
Fax machines
Health information regulatory compliance
Individual consumer customer service
NextGen
Health insurance referral requirements
Health information management
Clinical confidentiality policies
Faxing
Medical terminology

Full Job Description

This ON SITE position will work full-time, Monday - Friday, 80 hours bi-weekly. Hours are 8:30a - 5p.

Job Summary:

Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.

Under the direction of the Patient Access and HIM Manager and Department Lead, this position is responsible for patient insurance carrier referrals, insurance authorizations for in-house procedures/services, insurance eligibility, benefits, pre-determinations and price estimations. These responsibilities and requirements must be met prior to the delivery of ambulatory services. Responsible for verifying patient demographic and financial information for all insurances and self-pay accounts. Primary function of the Referral Authorization Specialist position is to provide premier customer service to internal and external customers in determining patient coverage, authorizations need, predetermination and patient estimations for care, in compliance with the No Surprise Act.

Example of Essential Functions:

Responsible to complete the pre-determination and authorization process prior to services being rendered
Extensive knowledge of all areas of registration and scheduling including on-site and outpatient services
Knowledge of medical insurance guidelines and participations agreements
Serves as primary resource for obtaining patients’ referrals.
Obtains primary care physician approval for patients’ referrals as required by the insurer.
Maintain a working knowledge of all insurance requirements related to referrals, authorizations, pre-determinations and medical necessity
Calculate price estimations, per payer fee schedule, prior to services being rendered
Maintaining updated knowledge of providers within the surrounding areas and insurance participation
Completes referrals for patients to participating providers within the appropriate network to maintain maximum financial incentives/reimbursement from payers as directed by the provider. Assists the providers and clinical staff in identifying the appropriate network/healthcare provider to use as a referral
Maintains knowledge of organizational quality metrics and goals
Maintain knowledge of online insurance eligibility verification systems
Collaborates with designated clinical contacts regarding encounters that require escalation for peer-to-peer review
Facilitates submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policies and procedures to maintain departmental productivity and quality goals.
Answers incoming phone inquiries related to referrals, pre-authorizations and medical necessity.
Review statistical data pulled from Cisco finesses to ensure time efficiency on calls and completing self-assessments as well as review assessments on calls reviewed by management
Offer to enroll patients in the patient portal when non-enrolled
All other duties as assigned

Required Knowledge, Skills and Abilities

Attention to detail, with the ability to analyze and determine the type of data needed to complete various types of patient registration functions.
Maintain a working knowledge of all insurance requirements for authorizations, referrals and price estimates.

Must demonstrate ability to manage time, deadlines, multiple request and priorities, maintain productivity and exercise good judgement with minimal supervision.
Clinical knowledge, to include medical terminology, medications, procedures/radiology, procedures and surgeries from all different medically specialty services.
Must have the ability to apply policies and procedures regarding data security and patient confidentiality (HIPAA) to prevent inappropriate release of patient information.
Proficiency in the use of computer software such as Microsoft Word, Microsoft Outlook, Microsoft Excel, NextGen, Meditech, Meditech Expanse, and the usage of the intranet. ability to operate a copier, fax machine, and printer
Excellent verbal and written communication skills to interact effectively with patients, customers, employees and Senior Leaders. Must demonstrate the ability to follow verbal and written instructions.
Always interacts with co-workers and other staff in a courteous and professional manner, and offering assistance as needed
Must be able to work in a changing environment, accept and give constructive criticism and feedback
Must work well with others in a team-oriented environment
Strong customer service background to include a pleasant disposition and high tolerance level

Minimum Education, Training, and Experience Required:

High school diploma or GED required. Some college coursework preferred related to Business/Health Sciences
A minimum of two years healthcare experience in revenue cycle billing and collections
A minimum of one year experience in obtaining authorization and pretermination
Understanding of medical terminology, CPT and ICD-10 codes
Extensive knowledge of health insurance plans including, Medicare, Medicaid, HMO’s and PPO’s required

Patient Contact

Must demonstrate and maintain current knowledge and skills in providing appropriate care/

Performance of job does not require patient contact

Physical Demands:

Sedentary - Light Work - Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

Working Conditions:

Bloodborne Pathogens Exposure Risk: Category C – NO exposure to blood or body fluids.

Reporting Relationship:

Reports to Director Revenue Cycle, Manager of Patient Access and HIM and Department Lead

Caring for you as you care for the CommUNITY
Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs. Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid, if applicable.

Hourly range: $17.51 - $22.66

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

authorization specialist jobs in frederick, md

Referral and Authorization Specialist - Practice Support

Authorizations Specialist

Medical Billing Specialist (Onsite)

Patient Care Coordinator

Billing Support Specialist I

Front Office Coordinator Float - Frederick, MD

Financial Intake Specialist - Frederick, MD Office

Program Administration Specialist

Full-Time Patient Relations Specialist - TRAINING PROVIDED

Registration Specialist - Plastic Surgery

Medical Assistant/Scribe

Medical Assistant

PART TIME - Front Desk Receptionist - Oral Surgery

Patient Access Specialist (FT, Days)

Front Office Coordinator - Westminster (PC), MD

BILINGUAL MEDICAL ASSISTANT

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