Role Overview
The Authorization Specialist III is responsible for verifying insurance policy benefit information, securing payer required authorization prior to the patient’s visit, scheduled admission, or immediately following hospital admission. This position is responsible for obtaining accurate and timely pre-authorizations for professional services.
What You Will Do
Verifies insurance coverage via system tools, payer portals, and phone calls. Updates changes in the billing system. Confirms provider’s participation status with patient’s insurance plan/network. Determines payer authorization requirements for professional services.
Why It Might Be a Fit
Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations. Must demonstrate a strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations.
Requirements
- High school graduate or GED certificate
- A minimum of 2 years’ experience in a physician’s billing or third payer environment
- Ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations
- Strong customer service and patient focused orientation
- Effective communication skills both verbally and written
- Ability to multi-task, prioritize, document, and manage time effectively
- Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
- Functional proficiency and comprehension of medical terminology
- Certified Professional Coder certificate (CPC) is preferred
- Experience in Epic and or other electronic billing systems is preferred
- Knowledge of medical terminology, diagnosis and procedure coding is preferred
- Previous experience in an academic healthcare setting is preferred
Benefits
- Healthcare
- Paid Time off
- Comprehensive Benefit package
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