Insurance Authorization Specialist
Job Posting for Insurance Authorization Specialist at SKYLINE CENTER, INC.
JOB SUMMARY: The Insurance Authorization Specialist is responsible for verifying eligibility, obtaining insurance benefits, ensuring pre-certifications, authorizations and referral requirements are met prior to the delivery of services to our individuals served. Staying on top of collections and auditing claims for error.
Essential Duties
Essential Duties
- Capable of performing and supervising prior authorizations and activities relating to billing and claims, including but not limited to Medicare, Medicaid, commercial insurance, and managed care companies.
- Provide excellent customer service to all parties at all times. Maintain a strong working relationship with payers, billing staff and others. Verify MCO, service authorization, start/end date, rate, code and units at the beginning of each month. Verify insurance benefits for each individual we serve. Work with payers and staff to obtain initial and ongoing authorization for individual we serve
- Investigate claim denials and work with each department to resubmit claims timely. Communicate with appropriate department status of claims, etc.
- Assist with coding and billing of all claims when necessary, act as backup in various departments.
- Researching, correcting and re-submitting rejected/denied claims. MCO credits Monitoring insurance aging for red flags and collections. Auditing claims for errors.
- Need to maintain strict confidentially and conduct yourself in accordance with HIPAA guidelines/regulations.
- Back up front office, answering phone and greeting visitors.
- Medicare cost report for home health, filed and received timely, PC-ACE quarterly updates, set up and bill Medicare patients via pc-ace system. Commercial insurance claims printed off PC-Ace system . applying for Medicare security official, allowing access to PS &R reports.
- Must be 18 years of age.
- High School Diploma or equivalent. AA/ B.A. business and accounting preferred.
- Experience in the medical service coding/ MCO/IME billing.
- Experience with Microsoft Word and Excel.
- Six months previous experience in customer service.
- Familiarity with medical terminology or willingness to learn.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
Sign up to receive alerts about other jobs that are on the Insurance Authorization Specialist career path.
Click the checkbox next to the jobs that you are interested in.
Sign up to receive alerts about other jobs with skills like those required for the Insurance Authorization Specialist.
Click the checkbox next to the jobs that you are interested in.
-
Auditing Skill
-
Income Estimation: $32,229 - $42,656
-
Income Estimation: $47,474 - $64,327
-
-
Billing Skill
-
Income Estimation: $29,993 - $38,118
-
Income Estimation: $34,255 - $43,540
-
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles
Skills Library
Job openings at SKYLINE CENTER, INC.
SKYLINE CENTER, INC.
Clinton, IA
Part Time
SKYLINE CENTER, INC.
Clinton, IA
Full Time
SKYLINE CENTER, INC.
Clinton, IA
Full Time
SKYLINE CENTER, INC.
Clinton, IA
Full Time
Not the job you're looking for? Here are some other Insurance Authorization Specialist jobs in the Clinton, IA area that may be a better fit.
We don't have any other Insurance Authorization Specialist jobs in the Clinton, IA area right now.
Mediabistro, Clinton, IA
Hammond-Henry Hospital, Geneseo, IL