Authorization Specialist - Pre-Certification Deparment

Position Description:
Schedule: Monday-Friday Day Shift

Location: Remote

Reviews databases and other pertinent documentation to ensure all needed pre-certifications and/or authorizations are completed for medical services. Works with all clinics and appropriate ancillary departments to ensure requirements are met through training, education and consultation. Must be familiar with and remain current of insurance carriers and requirements to include a working knowledge of referral and pre-certification processes and medical necessity guidelines. Must demonstrate exceptional customer service to patients, referring sources both internal and external.  This position requires the ability to effectively communicate information to the patient related to testing, required preparations, and financial obligations.  

Employee is required to work remotely after initial orientation.

Position Requirements:
EDUCATION AND EXPERIENCE:

Required: High school diploma or GED.  One (1) year of experience in Medical Billing or Authorization. Knowledge of insurance carriers, regulations, and processes with a desire to expand knowledge base. Strong work ethic to assure patient satisfaction in conjunction with protection of revenue for the organization. Extensive knowledge of Medical terminology and abbreviations. Basic computer skills.  Knowledge of Common Procedural Terminology (CPT); ICD-10.

Must:  (1) Attend all required course work assigned by management; (2) possess basic knowledge of medical terminology and advanced knowledge of PC applications, software, and database management;  (3) be able to perform math & bookkeeping skills; (5) possess exceptional telephone & customer service skills; and (5) be knowledgeable of English grammar & punctuation.  

Preferred:  Medicare and Medical Policies for other insurance carriers; documentation guidelines for medical service provision.  Undergraduate degree in administration or in a health related field; 1-3 years IDX experience.
1-3 years medical coding.

Employee must provide:

• High speed internet access
• Dedicated, secure and safe work space
• Noise-free environment to take patient calls

LICENSE, CERTIFICATION AND/OR REGISTRATION:

Required: None

Preferred: Certified Procedural Coder (CPC) certificate

TRAITS & SKILLS: Must be self-directed / self-motivated; must have good communication and interpersonal skills.  Must be able to: (1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) accept responsibility for the direction, control and planning of an one’s own work; (3) work independently; (4) recognize the rights and responsibilities of patient confidentiality; (5) relate to others in a manner which creates a sense of teamwork and cooperation; (6) communicate effectively; (7) exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment; (8) demonstrate the quality work ethic of doing the right thing the right way.