Authorization Specialist

Job Overview

We are seeking a detail-oriented and organized Authorization Specialist to join our team. The successful candidate will be responsible for processing, tracking, and ensuring the accurate and timely authorization of medical services, procedures, and insurance claims. The Authorization Specialist will work closely with healthcare providers, insurance companies, and patients to ensure all required approvals are obtained prior to services being rendered.

Key Responsibilities:

• Process and submit authorization requests for medical procedures, tests, and services in accordance with payer requirements.
• Communicate effectively with insurance companies, healthcare providers, and patients to gather necessary information for authorization approval.
• Ensure timely submission of prior authorizations and follow up on pending requests to obtain approval or resolution.
• Verify and track authorization status, maintaining accurate records in the system.
• Resolve issues and disputes related to authorizations, working as a liaison between providers, patients, and insurance carriers.
• Stay current on insurance policies, procedures, and regulatory changes affecting authorization processes.
• Collaborate with medical and administrative staff to ensure timely and accurate authorization of services.
• Ensure compliance with all health insurance regulations and guidelines.
• Maintain confidentiality and comply with HIPAA regulations.

Qualifications:

• High school diploma or equivalent (required); Associate’s degree or higher (preferred).
• Previous experience in a medical office, healthcare environment, or insurance authorization role (preferred).
• Knowledge of insurance types (commercial, Medicare, Medicaid) and their authorization processes.
• Strong attention to detail and accuracy in data entry and documentation.
• Excellent communication and interpersonal skills, with the ability to handle sensitive information.
• Proficiency with medical coding systems (ICD-10, CPT) and healthcare management software.
• Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
• Strong problem-solving skills and the ability to navigate complex issues.

Additional Skills (Preferred but not Required):

• Certification in Medical Billing and Coding (CPC, CBCS, etc.)
• Familiarity with healthcare regulations and insurance reimbursement policies.

Job Type: Full-time

Pay: $20.89 - $23.00 per hour

Expected hours: 40 per week

Benefits:

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

Ability to Commute:

• Columbia, MD 21045 (Required)

Ability to Relocate:

• Columbia, MD 21045: Relocate before starting work (Required)

Work Location: In person

Salary : $21 - $23