Authorization Specialist II

***Remote Position***

***Requires In-person Office Training and Applicant Should Reside in Texas***

***This Position is supposed to work Nights and Weekends***

***Applicants should be able to do on-site training during day shifts for the first 30-45 days***

The Authorization Specialist II primary responsibility is ensuring the correct insurance is verified and identified for authorization requirements. General duties include working off of a report to upload to a google doc, verifying patient insurances and submitting authorization for non-emergency transports at the correct level of service. As well as have a working knowledge of medical abbreviations, terminology and insurance portals for verification. The employee will need to complete position responsibilities by following established guidelines and protocols within the appropriate time frame, and must be flexible with his/her work schedule. Employee is required to speak to clients via phone and must exhibit good phone etiquette, including grammar and ideal customer service skills. This position involves discretion and independent action within prescribed limits. The employee should have the ability to work independently and self-efficiently.

Responsibilities:

• Answering Phones for Auth Appointment Scheduling, answering questions, taking messages and forwarding calls as applicable
• Communicating with facilities for obtaining Face sheets, Medical Necessity *(PCS) or other clinical information required/missing for non-emergent runs
• Communicating with patients/facilities/Case Managers etc - regarding required documentation prior to scheduling transports/appointments
• Calculating and processing PRIVATE PAY runs which must have payment in advance prior to scheduling
• Calculating and completing LOA forms for facilities for applicable pre-scheduled runs where the patient is uninsured or insurance does not cover the service
• Answering/addressing emails sent by Dispatch for questions or requests and ensuring appropriate communication with Dispatch and other applicable departments
• Uploading/working applicable non-emergent runs from the prior and current day
• Verify patient Insurance to ensure coverage of requested for appointments/prescheduled services – MUST appropriately recognize/identify patient insurances and the coverage limits that may be applicable
• Noting accounts clearly and effectively regarding attached sub docs, pcs-if required, insurance located and PAN requirements
• Updating Demographics such as name, DOB and appropriate Insurances as necessary in the system
• Submitting Authorization as required and ensuring all applicable codes, information required and applicable sub docs were submitted to the appropriate payer

Skill Sets Required:

• MUST exhibit excellent communication skills, both verbal and written as well as proficient typing skills. ALWAYS BE PROFESSIONAL
• An excellent working knowledge of Excel and/or Microsoft office and Google Docs
• This position requires a positive attitude and personable demeanor.
• Excellent time management and organizational skills with special attention to detail.
• Insurance Verification and Web Portal knowledge
• Prior Authorization Submission and Status Experience
• Basic Medical Terminology and understanding

EDUCATION & EXPERIENCE

· High school diploma or GED required

· Minimum 2 years of experience in Insurance Verification

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)
• Pre Authorization: 1 year (Required)

Location:

• Houston, TX (Required)

Work Location: Remote

Salary : $20 - $22