Authorization Specialist

Authorization Specialist

Classification: Non-Exempt

Reports to: Revenue Cycle Manager

Date: June, 2024

Summary/Overview:

The Authorization Specialist is responsible for obtaining, documenting, and attaching authorizations to encounters prior to billing for E&M’s and procedures. Reporting directly to the Revenue Cycle Manager, the Authorization Specialist will assist with revenue and billing operations within their scope. Primary Duties and Responsibilities • Verify patient’s insurance is accurate prior to investigating authorizations. • Verify patient’s if authorization is needed for services. • Attach authorization number to the patient’s account, unbilled claims and rebill claims where the number was missing from the initial claim. • Follow up on required authorizations for billed claims that can be back dated. • Work denials related to missing authorization to determine if the insurance needs to be added to the authorization list or if claim is still viable for payment. • Reach out to facilities if authorization for our services can be covered by the facility’s authorization number. 

Education & Experience • High School Diploma or equivalent • 1 year experience in a healthcare billing setting

Qualifications • Knowledge of insurance billing guidelines • Prior experience with authorization and tools to obtain (ex. Insurance portals) • Detail oriented, problem solver/analytical, flexible, and self-motivated • Proficiency with Microsoft (Outlook, Office Word, and Excel) • Organized, ability to multi-task in a fast-paced environment • Works well independently and in a team setting • Ability to type 45+ words per minute

Physical Requirements While performing the essential functions of this job, the following are required: · Talk, hear, and communicate with people over the telephone; · Use hands and fingers to operate a computer and telephone; · View computer screens for extended periods of time; · Sit at a desk for extended periods of time; and · Regular, predictable attendance.

Work Location Requirements · The job duties and functions for this position are performed 100% remotely.