What are the responsibilities and job description for the Authorizations Specialist position at Orthopedic Centers of Colorado?
Description
Position Overview:
The Authorization Specialist is responsible for managing and processing authorization requests for services, procedures, and equipment within the organization. This role ensures that all necessary approvals are obtained before services are rendered, in compliance with internal policies, payer guidelines, and regulatory requirements. The Authorization Specialist collaborates with healthcare providers, insurance companies, and patients to facilitate timely and accurate authorization processes.
Essential Functions
REQUIRED QUALIFICATIONS AND SKILLS:
Position Overview:
The Authorization Specialist is responsible for managing and processing authorization requests for services, procedures, and equipment within the organization. This role ensures that all necessary approvals are obtained before services are rendered, in compliance with internal policies, payer guidelines, and regulatory requirements. The Authorization Specialist collaborates with healthcare providers, insurance companies, and patients to facilitate timely and accurate authorization processes.
Essential Functions
- Authorize occupational therapy services and equipment with insurance.
- Verify eligibility and benefits for all procedure codes.
- Document work processes as required
- Coordinate processes and route all paperwork as required to meet therapy requirements
- Must be able to recognize and respond appropriately to urgent /emergent situations.
- Follow all written protocols and procedures of the clinic including the OCC handbook, CSO appendix and all department policy and procedures
- Demonstrate courtesy and helpfulness toward patients and / or their families.
- Ensure efficient telephone communication when required
- Work as a team member within the authorizations department and all other departments
- Perform other duties as assigned by therapy leadership
REQUIRED QUALIFICATIONS AND SKILLS:
- Medical terminology
- ICD-10 and CPT coding knowledge
- Knowledge of contracted insurance plans and procedures
- Solid computer and phone skills
- Strong organizational and interpersonal skills
- Ability to prioritize responsibilities and multi-task efficiently and effectively
- Medical, Dental and Vision Insurance
- Generous PTO package and paid holidays
- Company-paid life insurance and long term disability insurance
- Ability to purchase accident insurance, short and long-term disability insurance.
- Opportunities for internal training and development
- Retirement Plan eligibility after one month of service with eligibility in company profit sharing
- Most positions offer Monday – Friday work schedules
- Typical business office environment
- Possibility of local travel
- Constant viewing of computer monitor, mousing and typing
- Frequent standing, walking and sitting
- Frequent stooping, lifting, carrying and pushing/pulling 10 pounds or more
- Occasionally lift and/or move up to 50 pounds
- Specific vision abilities required by this job include close vision, color vision, peripheral vision, and ability to adjust focus
- Hours of business are Monday – Friday from 8:00 a.m. to 5:00 p.m. Must be able to work early, late and long hours, as needed, to meet the essential functions of the job
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