Procedural Authorization Specialist

Job Summary:

The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all information is coded correctly to obtain authorizations for maximum reimbursements

Associates Degree and two years relevant patient financial/insurance services experience (preferably in a healthcare setting) or equivalent combination of education and experience. Working knowledge of medical terminology, familiarity with medical coding and written/oral communication skills required. Excellent problem solving skills, computer and keyboarding skills required. This position requires strong knowledge of ICD, CPT, and J codes to effectively communicate all information to insurance carriers.

Ability to maintain good public relations with patients, families, co-workers and other individuals as necessary.

Prior experience working with ambulatory patient care administrative functions, collecting/analyzing data, organizing appropriate record keeping systems and outside agencies such as insurance carriers, CMS, billing companies and/or other support agencies preferred. Knowledge of medical billing requirements and ability to recognize insurance fraud/abuse strongly preferred. Experience with medication reimbursement, medications, physician orders and insurance claim submission. Experience with healthcare insurance prior authorization/coding and performing insurance carrier/managed care review preferred.

Mon-Friday days

Recruitment Office:
Human Resources