Authorizations and Benefits Specialist

We are looking for an experienced Authorization and Benefits Specialist to perform prior authorizations and insurance verifications. The Authorization Specialist is responsible for processing incoming and outgoing authorizations and insurance benefit verifications, communicating with patients about insurance benefits and issues, authorizations, and appointment scheduling, responds to incoming billing questions, and confirms authorization and submits timely authorization appeals.

Responsibilities:

• Reviews daily incoming faxes, emails and bins to process requests and referrals and dispersing to others as needed.
• Contacts patients about insurance issues, deductibles, or C-Ins and cancel appointments as needed.
• Daily reviews Referrals Work Queue to confirm the required authorizations; inputs proper information to the Referral Module.
• Obtains authorizations/referrals from insurance companies or PCP.
• Assign referrals to appointment after inputting authorization information in the "Referral Module"
• Verifies benefits for all appointments.
• Post MRI charges and complete the MRI Log daily.
• Post patient payments
• Processes authorization appeals in a timely manner.
• Answer any incoming billing questions via phone or live.
• Cross trains and performs the responsibilities of the Billing and Collection Specialist during down time.
• Participate in educational activities.
• Maintains strictest confidentiality.
• performs related work as required.

Knowledge, Skill and Experience:

• High School Diploma or GED required.
• Minimum one-year medical billing office or patient account processes.
• Knowledge of insurance reimbursement procedures and practices preferred.
• Knowledge of medical terminology preferred.
• Strong organizational skills
• Ability to prioritize work during heavy workload situations
• proficient in Windows Environment and Microsoft Office
• Have excellent written and oral communication skills, excellent telephone etiquette skills
• Experience with medical record; Previous EHR experience, epic a plus
• Ability to work independently, and work effectively as a team contributor on day-to-day assignments
• Ability to maintain quality control standards.
• Ability to interpret, adapt and apply guidelines and procedures.
• EMR/EPIC

Benefits

• 401(K)
• Dental Insurance
• Disability insurance
• Employee assistance program
• Health Insurance
• Health savings account
• Life insurance
• Paid time off
• Vision Insurance