Patient Access Insurance Authorization Specialist- Full Time
Job DescriptionThe Insurance Authorization Specialist supports the Patient Access Department by accurately verifying insurance information, reviewing patient accounts for prior authorization needs, obtaining needed prior authorizations, and properly documenting all steps in the processThis position will also serve as a point of contact for clients and coworkers to ensure we process our insurance verification and authorization efforts to best care for our patientsThis position may assist with training and mentoring other staff members as well as being available in the same capacity for our clients as neededThis position plays a key role in providing a smooth experience for patients and ensuring the organization receives appropriate reimbursement.Principal Duties and ResponsibilitiesUtilizes online systems, phone communication, and other resources to determine insurance eligibility and prior authorization needs for a scheduled patient event.Verifies benefits, extent of coverage, pre-certification and pre-authorization requirementsPlus other limitations within a timeframe before scheduled appointments determined by Jennie Stuart Health.Follows prior authorization work flow, policies and proceduresCollaborate with other departments to assist in obtaining pre-authorizations in a cross functional mannerManage correspondence with insurance companies, physicians, specialists and patients as requiredCreate patients' records and accounts and ensure that pre-authorization information is properly updated in themeffectively communicating with patients, physicians, clinicians, front-end staff, and translatorsCoordinates benefits by effectively determining primary and secondary liability when neededObtains pre-certifications and pre-authorizations from third-party payers in accordance with payer requirementsAlerts physician offices and patients to issues with verifying insurance or meeting pre-authorization requirementsAssists in training new insurance verification staff in accordance with organization's standardsComplies with all state and federal laws and regulations related to patient privacy and confidentiality, such as HIPAAPerforms other clerical duties as assigned by Patient Access Director and/or managerExhibits professionalism in appearance, speech, and conduct; ensures that services are provided in accordance with organizational standards and policiesExperience as an Insurance Verification and Referrals within the organization, or at least two to three years of insurance verification or healthcare administration experience outside the organization requiredCustomer service experience preferredProficient knowledge of the following:
EHR programs (e.g., Sunrise, AllScripts and Athena, etc;)Medical terminologyICD-10, CPT, HCPCS codes, and coding processesVarious payer regulations and contractsAbility to motivate and mentor othersKnowledge of other front-end processes, including scheduling, pre-registration, financial counseling, medical necessity, and registration.Superb teamwork and conflict resolution skillsEfficient time management skills and ability to multitaskExcellent writing, oral, and interpersonal communication skillsStrong understanding and comfort level with computer systemsRequired Skills Experience with insurance verification and referrals within the organization, or at least two to three years of insurance verification or healthcare administration experience outside the organization requiredCustomer service experience preferredProficient knowledge of the following EHR programs (e.g., Sunrise, AllScripts, Athena, etc; )Medical terminologyICD-10, CPT, HCPCS codes, and coding processesVarious payer regulations and contractsAbility to motivate and mentor othersKnowledge of other front-end processes, including scheduling, pre-registration, financial counseling, insurance authorization, medical necessity, and registration.Superb teamwork and conflict resolution skillsEfficient time management skills and ability to multitaskExcellent writing, oral, and interpersonal communication skillsStrong understanding and comfort level with computer systemsRequired ExperienceEducation:
High school diploma or GED requiredAssociate or bachelor's degree in healthcare administration or related field preferredCertified Healthcare Access Associate (CHAA) certification preferred Recommended Skills Cpt Coding Coaching And Mentoring Communication Confidentiality Conflict Resolution Contract Management Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3v5xw6c7r4z1yr2y0h', 'ExternalApply-j3v5xw6c7r4z1yr2y0h'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
EHR programs (e.g., Sunrise, AllScripts and Athena, etc;)Medical terminologyICD-10, CPT, HCPCS codes, and coding processesVarious payer regulations and contractsAbility to motivate and mentor othersKnowledge of other front-end processes, including scheduling, pre-registration, financial counseling, medical necessity, and registration.Superb teamwork and conflict resolution skillsEfficient time management skills and ability to multitaskExcellent writing, oral, and interpersonal communication skillsStrong understanding and comfort level with computer systemsRequired Skills Experience with insurance verification and referrals within the organization, or at least two to three years of insurance verification or healthcare administration experience outside the organization requiredCustomer service experience preferredProficient knowledge of the following EHR programs (e.g., Sunrise, AllScripts, Athena, etc; )Medical terminologyICD-10, CPT, HCPCS codes, and coding processesVarious payer regulations and contractsAbility to motivate and mentor othersKnowledge of other front-end processes, including scheduling, pre-registration, financial counseling, insurance authorization, medical necessity, and registration.Superb teamwork and conflict resolution skillsEfficient time management skills and ability to multitaskExcellent writing, oral, and interpersonal communication skillsStrong understanding and comfort level with computer systemsRequired ExperienceEducation:
High school diploma or GED requiredAssociate or bachelor's degree in healthcare administration or related field preferredCertified Healthcare Access Associate (CHAA) certification preferred Recommended Skills Cpt Coding Coaching And Mentoring Communication Confidentiality Conflict Resolution Contract Management Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3v5xw6c7r4z1yr2y0h', 'ExternalApply-j3v5xw6c7r4z1yr2y0h'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
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