Authorization Specialist

Looking for an exciting opportunity as an Authorization Coordinator in a dynamic and supportive team environment?

Join us at Eagle Physical Therapy and Rehabilitation and take your career to new heights! We are searching for individuals who thrive in fast-paced settings, love solving problems, and are dedicated to ensuring smooth processes.

As an Authorization Coordinator, you will play a pivotal role in obtaining pre-authorization for crucial medical procedures. This dynamic position involves collaborating with payers, patients, and clinical staff to ensure that services are authorized, and patients receive the care they deserve. You will also oversee the efficient processing of patient referrals and ensure seamless coordination with our outstanding in-house clinicians. This is your chance to ensure that every patient receives top-notch care and be a part of our commitment to quality assurance and patient advocacy at the forefront.

Don't miss this opportunity to unlock your potential and make a real difference here at Eagle Physical Therapy and Rehabilitation!

Essential Duties

• Serve as the primary resource for insurance eligibility and benefits for therapy services, handle prior authorization, collect patient information, advise on financial obligations, and collect payments courteously and professionally.
• Contact insurance companies via phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information.
• Communicate with service line partners about rescheduling due to lack of authorization or limited benefits, with approval from clinical personnel.
• Ensure all services have proper authorization and promptly inform payers of patient visits to safeguard financial stability. Escalate any unauthorized accounts or visits to management.
• Process incoming patient referrals and coordinate internal staffing by referring patients to in-house clinicians.
• Document all benefits (copays, deductibles, co-insurance), authorizations, pre-certifications, and financial obligations of patients clearly and accurately to ensure expeditious processing of patient accounts and denial prevention.
• Maintain a close working relationship with clinical partners and ancillary departments to ensure open communication. Collaborate with Case Management and Utilization Review to support authorization to the payer.
• Gather additional clinical or coding information as necessary to obtain prior authorization.
• Stay informed and research information regarding insurance criteria for prior authorization.
• Attend department staff meetings, professional education sessions, complete e-learnings, and mandatory training.
• Maintain accurate and complete documentation in patient charts and cultivate strong relationships with insurance companies, physicians, and medical office staff.
• Communicate effectively with the facility as necessary and assign appropriate ICD and CPT codes based on documentation and booking slips before the operation.
• Serve as a resource for insurance, billing, and customer service for reception.
• Perform other assigned duties.

Required Skills

• Effective communication with patients and teammates.
• Ability to handle multiple tasks simultaneously.
• Strong interpersonal skills.
• Strong customer service skills.
• Ability to work in a fast-paced environment.
• Problem-solving abilities.
• Ability to take responsibility for actions.

Basic Qualifications

Education:

• High school diploma or general education degree

Experience:

• Two years of related medical office experience (preferred)
• Accurate data entry skills
• Current knowledge of payer requirements for referrals and preauthorization
• Knowledge of ICD-9 and CPT coding
• General understanding of back-office operations
• PC proficiency
• Medical terminology (preferred)

Location: Baltimore

Hours: Monday through Friday, Starting at 9:00 am

Job Types: Full-time, Part-time

Benefits:

• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible schedule
• Employee Assistance Program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift

Work setting:

• In-person

This organization is an Equal Opportunity Employer and does not discriminate based on race, color, ancestry, nationality, national origin, immigration status, ethnic group identification, ethnicity, age, religion, marital status, pregnancy, pregnancy status, physical or mental disability, sex, sexual orientation, gender, gender identity, gender expression, or genetic information; a perception of one or more of such characteristics; or association with a person or group with one or more of these actual or perceived characteristics. Inquiries regarding compliance procedures may be directed to our personnel office.

Job Type: Full-time

Pay: From $21.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Ability to Commute:

• Baltimore, MD 21202 (Required)

Ability to Relocate:

• Baltimore, MD 21202: Relocate before starting work (Required)

Work Location: In person

Salary : $21