What are the responsibilities and job description for the Authorization Specialist position at Ozark Center?
Job Description Summary: Minimum starting salary $15.00 / hour
The Authorization Specialist is responsible for completing the insurance pre-approval process for medical procedures, treatments, and medications. This role requires a detail-oriented individual with strong communication skills to interact with insurance companies, healthcare providers, and patients. The specialist ensures that all necessary documentation is submitted accurately and timely to obtain insurance approvals, ultimately facilitating patient care while adhering to insurance requirements and organizational policies. The specialist will be trained in trauma-informed care and will work to help provide access to services in an environment that is sensitive and responsive experience and needs of the patient. The authorization specialist will report to the Nurse Coordinator of Adult Psychiatric Practices.
Education: High School diploma or equivalent.
Responsibilities:
1. Submit and track prior authorization requests for medical procedures, treatments and medications.
2. Verify patient insurance eligibility and benefits coverage.
3. Gather and review clinical documentation to support authorization requests.
4. Communicate with healthcare providers to obtain additional information as needed.
5. Follow up on pending authorizations and appeal denied requests when appropriate
6. Maintain accurate records of all authorization activities in the EHR.
7. Serve as a liaison between patients, providers, and insurance companies regarding authorization status.
8. Ensure compliance with HIPAA regulations and maintain patient confidentiality.
9. Maintain current knowledge of insurance policies, procedures, and requirements.
10. Perform other duties as assigned by the Nurse Coordinator or Program Director.
Physical Requirements: Normal office environment. Typical demands include prolonged sitting, frequent standing, bending, stooping, and occasional lifting. Requires normal range of hearing and manual dexterity sufficient to operate keyboard, telephone, photocopier, calculator, and other office equipment as needed. Requires ability to remain calm during stressful events, to occasionally work irregular hours, and work with exasperated individuals. Occasional lifting up to 50 pounds.
Salary : $15
