Posted Jun 03, 2023 181 views
Insurance Authorization Specialist
Hubkom Solutions is currently seeking an Authorization specialist to join our team. As an Authorization specialist, you will play a vital role in ensuring that all necessary approvals and authorizations are obtained for various processes and activities within the organization.
Responsibilities
- The Insurance Authorization Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers
- Review chart documentation to ensure the patient meets medical policy guidelines
- Prioritize incoming authorization requests according to the urgency
- Obtain authorization via the payer website or by phone and follow up regularly on pending cases
- Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations
- Communicates with the ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm the accuracy of CPT and ICD-10 diagnoses in the procedure order
- Contact patients to discuss authorization status
QUALIFICATIONS
- Previous experience in pre-authorization/pre-certification and processing of health insurance claims
- Medical terminology
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Excellent computer skills including Excel, Word, and Internet use
- Detail-oriented with above-average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
SCHEDULE
- 8 hour shift
- Night shift
- Monday to Friday ((6:00 P.M. to 3:00 A.M.)
Job Details
Hubkom Billing Solutions
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