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Medical Authorization Specialist
BruntWorkManila, 00, ph7 days ago
Job type
- Quick Apply
Job descriptionDirectly responsible for processing all face sheets in a timely fashion to prevent patient care issues. Resolve issues and conflicts that arise between insurances and provided information. Resolve insurance authorizations denials as they arise and research independently to make corrections quickly and accurately. Work with teams to ensure all applicable patients are have authorizations quickly. Ensure that common denials are reported to Revenue Cycle manager for continued staff training and correction. Follows all communication protocols for contacting manager on a regular basis. Creates and reviews reports and other operational documents to process and verify insurance information. In partnership with manager, identifies performance and process improvement opportunities to create operational efficiencies, leading to an improved work environment and minimal errors. Participates in development programs and services that address specific aspects of the processes within their service area. Follow monitoring and tracking systems to ensure timely and accurate processing of information. Ensure pending authorizations are processed in a timeline set by KPI goals and patient volume. Providing regular updates / reports to manager. Collaborate with manager to identify process improvements and staff education / training needs to ensure timely and accurate billing processes occur across the patient journey, resulting in timely and accurate filing of claims. Ensure current insurance information is being used for all patients while adhering to all organizational billing policies and procedures. Participate in ongoing professional development as provided by the company, and self-directed learning. Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency. Maintain confidentiality by safeguarding ePHI and demonstrating HIPAA compliance to our patients. Ensure that HIPAA privacy policies are clearly understood and followed. Punctual and regular attendance is an essential responsibility of each employee at the company. Employees are expected to report to work as scheduled, on time, and prepared to start working. Employees also are expected to remain at work for their entire work schedule. Late arrival, early departure, or other absences from scheduled hours are disruptive and must be avoided.The list of job duties and requirements is not all-inclusive. Management, at its discretion, may assign additional duties. Required : Possession of a high school diploma or GED. Preferred : Two or more years of experience working in authorizations. Preferred : Experience using eClinicalWorks Practice Management software. Knowledge of Medicare / Medi-Cal rules and regulations and CPT and ICD-10 coding. Knowledge of private, Medi-Cal and Medi-Care insurance rules and regulations. Ability to prioritize department duties and effectively allocate tasks to the team. Must have a good understanding of industry regulations and standards, including those related to patient privacy and safety. Problem-solving skills : Analyzing complex problems, developing creative solutions, and making sound decisions. Proficiency with Microsoft Excel (e.g., formulas, pivot tables). Attention to detail (requires a high level of accuracy). Ability to handle conflicts and challenges professionally and constructively. Advanced interpersonal communication skills (able to effectively relate via the telephone and online to serve the needs of manager in an efficient and productive manner). Strong written communication. Cultural sensitivity and demonstrated ability to work with diverse people groups. Time management and organizational skills : prioritizing tasks, meeting deadlines, and staying organized. Must have a good understanding of the technical aspects of their job, including any software or equipment they are required to use. Adapt to changing situations and environments, including new technologies, processes, or organizational changes. Decision making : Engage in a methodical process of generating and assessing various alternatives before deciding. HMO Coverage for eligible locations Permanent work-from-home Immediate hiring
Job Description
This is a remote position.
Fixed Schedule :
- Monday to Friday 8 AM - 5 PM PST
Position Summary
The Authorization Specialist is responsible for providing accurate insurance authorizations, verification of insurance, and customer service. Responsible for ensuring the performance, productivity, efficiency, and profitability of operations.
The Authorization Specialist plays a key role in helping to develop a positive and healthy culture within their area of responsibility, including working cross-departmentally, developing mutually beneficial, strategic relationships with staff at all levels to ensure ongoing process improvement and open and productive collaboration.
Main Responsibilities
Administrative Responsibilities
Functional Responsibilities
Additional Responsibilities
Requirements
Education
Experience
Knowledge, Skills, and Abilities
Benefits
ZR_27686_JOB
Requirements
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