What are the responsibilities and job description for the Authorization Specialist position at Alliance Health System?
Job Description
Job Description
Authorization Specialist
Authorization Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers.
RESPONSIBILITIES
- Review chart documentation to ensure patient meets medical policy guidelines
- Prioritize incoming authorization requests according to urgency
- Obtain authorization via payer website, fax or by phone and follow up regularly on pending submission
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
- Initiate appeals for denied or modified authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
EDUCATION / EXPERIENCE REQUIRED
Work Remotely :
Benefits :
