Job Description

Authorization Specialist

Handles the verification of insurance benefits for patients. Notifies patient of deductibles and co-insurance due as needed. Contacts primary care physicians in regard to referrals. Requests referrals for services, including appointments and procedures. Regularly calls insurance companies to follow up. Explores other payment options with customer when needed. Keeps sensitive patient and company information confidential. Contacts patient when needing to obtain information. Requests, tracks, and obtains pre-authorization from insurance carriers within time allotted for medical and services. Reviews patient's medical history and insurance coverage for approval. Contacts referring physicians for additional information as needed. Inputs new patient information and updates information in our system. Monitors schedule for potential issues. Completes billing documentation. Assists with other clerical tasks as needed. Secures prior authorizations prior to services being performed. Demonstrates and applies knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations. Communicates any insurance changes or trends among team. Maintains a level of productivity suitable for the department. Clearly documents all communications and contacts with providers and personnel in standardized documentation requirements, including proper format. Regular attendance required. Performs other related duties as assigned or requested. The company reserves the right to add or change duties at any time.

Education: High School diploma or GED required

Experience: Minimum 2 years of workers compensation

Experience: Minimum of 1 year experience as a medical biller/coder. Experience with electronic scheduling system and electronic medical records (EMR) required. Familiar with medical terminology.

Knowledge: Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

Skills: Skill in identifying patient concerns and correcting or notifying supervisor. Actively listening and speaking to patients and understand and ask questions to ensure patient experience is at the highest level. Ability to read and write instructions, and comprehend simple instructions, short correspondence, and memos. Ability to competently use Microsoft Office.

Department: Business Office

Immediate Supervisor Title: Authorizations Department Lead

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