The 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 process. This 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 patients. This position may assist with training and mentoring other staff members as well as being available in the same capacity for our clients as needed. This position plays a key role in providing a smooth experience for patients and ensuring the organization receives appropriate reimbursement.
Principal Duties and Responsibilities
Required 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 required
- Customer service experience preferred
- Proficient knowledge of the following EHR programs (e.g., Sunrise, AllScripts, Athena, etc; )
- Medical terminology
- ICD-10, CPT, HCPCS codes, and coding processes
- Various payer regulations and contracts
- Ability to motivate and mentor others
- Knowledge of other front-end processes, including scheduling, pre-registration, financial counseling, insurance authorization, medical necessity, and registration.
- Superb teamwork and conflict resolution skills
- Efficient time management skills and ability to multitask
- Excellent writing, oral, and interpersonal communication skills
- Strong understanding and comfort level with computer systems
Required Experience
Education:
- High school diploma or GED required
- Associate or bachelor’s degree in healthcare administration or related field preferred
- Certified Healthcare Access Associate (CHAA) certification preferred