Description

POSITION SUMMARY 

Our company is growing rapidly and searching for experienced candidates for the position of Revenue Cycle Management - Authorizations Specialist. If you are looking for a full time position please look at the qualifications below. 

ESSENTIAL DUTIES AND RESPONSIBILITIES 

The essential functions include, but are not limited to the following: 

• Must be available from the hours of 8 am-5 pm CT Monday – Friday 
• Manage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriate 
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Review accuracy and completeness of information requested and ensure that all supporting documents are present 
• Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial 
• Receive requests for prior authorizations through the electronic health record (EHR) and/or via phone or fax and ensure that they are properly and closely monitored 
• Using knowledge of required authorizations, maintain tracker of all procedures requiring auth and pertinent details 
• Ability to use portals to verify active insurance and coverage types, determining patient responsibility and OOP 
• Follow up on missing or inaccurate information including coordination with clinical staff and physicians as well as all referrals to ensure no care gaps 
• Ensure authorizations are available prior to patient appointments and in patient chart 
• Ability to maintain good relationships with patients, providers and coworkers 
• Communicate patient’s financial obligations if applicable 
• Update demographic information as necessary 
• Informs appropriate staff/patient of authorizations/referral requirements 
• Staying current with insurance requirements, maintaining trackers with denied claims and problem solving as applicable Comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment 
•  Ability to work hand in hand with 3rd party RCM company 

Requirements

• Self-starter with the ability to work independently and as part of a medical office team 
• Strong attention to detail with a high degree of accuracy 
• Ability to prioritize and multi-task when presented with multiple duties throughout the day such as phone calls, emails, and active chats 
• Excellent math skills 
• Two years experience in a medical facility 
• Bachelor’s in Medical Admin, Healthcare Administration or Associate with 5 years’ experience 
• Working knowledge of medical terminology, and correct spelling of medications 
• Strong grammatical skills 
• Proficient on computer and typing, use of Google Apps 
• Communication skills 
• Strong customer service skills