Hourly Wage for SOUTHEASTHEALTH Medical Authorization Specialist Salary in the United States
How much does an Medical Authorization Specialist make hourly at companies like SOUTHEASTHEALTH in the United States? The average hourly wage for an Medical Authorization Specialist at companies like SOUTHEASTHEALTH in the United States is $23 as of April 24, 2024, but the range typically falls between $20 and $26. Hourly rate can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession. With more online, real-time compensation data than any other website, Salary.com helps you determine your exact pay target. View the Cost of Living in Major Cities
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What does an Medical Authorization Specialist do at companies like SOUTHEASTHEALTH?
The Medical Authorization Specialist is responsible for multiple facets of patient financial account services within the practice; including but not limited to patient benefit assessment, insurance verification (pre-certification, authorizations, determination) for services, and referrals management
Begin
- Verify prior authorizations and/or pre-service requirements are met.
- Organize and file insurance prior authorization documentation within the patient chart.
- Reviews studies on a daily basis while meeting or exceeding all daily, weekly and monthly production goals.
- Prioritize incoming authorization requests according to urgency.
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Contact patients as necessary to verify insurance information to obtain the required prior authorization and to discuss authorization status.
- Request, track and obtain prior-authorization from insurance carriers within time allotted for imaging studies.
- Document eligibility, benefit and authorization information in accordance with established guidelines.
- Update scheduled appointments to include referral and prior-authorization requirements in scheduling system
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
- Initiate peer-to-peer reviews for denied authorizations
- Follow and maintain spreadsheet for VA authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Demonstrate and apply knowledge of medical terminology.
- Communicate any insurance changes or trends among team.
- Maintains a level of productivity suitable for the department.
- Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
- Maintain current and detailed knowledge of third-party payer requirements
- Communicates and works effectively with colleagues from other departments.
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Meets deadlines by planning and prioritizing work as assigned
- Other duties as assigned.
Become
- High School graduate required
- Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
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