Authorization Specialist

Authorization Specialist

Job Title: Authorization Specialist

General Summary of Duties: Performs various clerical duties; answering telephones, taking messages, scheduling appointments, copying, and creating/filing charts. Responsible for data entry, patient account follow up.

Supervisor: Office Manager

Major Responsibilities/Tasks:

• Answer and screens telephone calls in a courteous manner, and record messages for physician and other personnel.
• Schedule patient appointments and procedures according to established policies and procedures.
• Obtain accurate information from patients.
• Monitors incoming patient orders and gathers information needed to complete the pre-authorization and scheduling of an order. You will evaluate portions to be paid by the customer as well as perform all insurance related assignments as instructed.
• Provide information to patients regarding unpaid balances.
• Coordination of referrals, verify that the referrals are complete, send confirmation of appointment to the PCP and/or referring provider, confirm that the consult letters are sent after the appointment.
• Communicate with primary care providers and referring providers regarding referrals and coordinate the exchange of information regarding the patient.
• Communicate with insurance companies and primary care providers to obtain authorization for services.
• Communicate and coordinate referrals with Healthy Start program and any communication with Healthy Start representative.
• Maintain files and records in a confidential manner.
• Maintain organization and efficiency of front office, including office supply inventory.
• Maintain patient confidentiality.
• Perform other related duties as directed or assigned.

EDUCATION: High school diploma or GED.

EXPERIENCE: Minimum of two years of administrative assistant experience in a medical office, including coordinating referrals & authorizations.

Performance Requirements:

Knowledge:

1. Knowledge of clinic policies and procedures.

2. Knowledge of medical terminology and insurance practices.

3. Knowledge of computer programs and applications.

4. Knowledge of grammar, spelling, and punctuation to type from draft copy and review and edit reports and correspondence.

Skills:

1. Skill in operating office equipment

2. Skill in handling paperwork/filing adequately.

3. Skill in handling incoming phone calls and triaging appropriately.

4. Skill in written and verbal communication.

5. Skill in gathering, interpreting, and reporting insurance information.

6. Skill in trouble-shooting insurance claims issues and resolving appropriately.

Abilities:

7. Ability to work effectively as a team member with physicians and other staff.

8. Ability to sort and file materials correctly by alphabetic or numeric systems.

9. Ability to interpret and understand insurance benefits and reimbursement.

10. Ability to flexibly respond to changing demands.

11. Ability to organize and prioritize tasks effectively.

12. Ability to communicate clearly.

13. Ability to work with little supervision.

14. Ability to establish and maintain effective working relationships with patients, employees, and the public.

Equipment Operated: Office machinery including computers, fax, dictating machine, calculator, and photocopier.

Occasionally lift and carry files up to 20 pounds.

Work Environment: Work performed in office environment. Involves frequent contact with staff and patients. May require working under stressful conditions.

Mental/Physical Requirements: Manual dexterity for office machine operation including computer and calculator; stooping, bending to handle files and supplies, mobility to complete errands or deliveries, or sitting for extended periods of time. Stress can be triggered by multiple staff demands and deadlines.

Disclaimer: This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

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Job Type: Full-time

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Administrative assistance: 2 years (Preferred)

Work Location: One location