ADMIN II - AUTH

Description

Job Title: Administrative Staff II - Authorization/Verification Specialist
Date Updated: January 2020
Direct Report: Lead Admin
FLSA Status: Non-Exempt/Full-Time
Hours Worked: 40 /week

Proficiently perform all tasks required for the purpose of insurance verification, benefits and eligibility and prior authorization in a radiology setting.

Duties:

1. Answer incoming calls in a prompt and pleasant manner, in all job capacities.
2. Obtain authorizations and eligibility in a timely manner with comprehensive documentation.
3. Schedule, coordinate, reschedule and confirm patient appointments. Relay necessary messages to staff.
4. Obtain insurance information regarding co-pays, deductibles and percentage payments.
5. Verify patient information and thoroughly document necessary information in RIS system.
6. Inform patients of any balance due.
7. Assist with faxing, printing reports.
8. Question patients regarding prior exams and history and notify them of protocols for scheduled procedure.
9. Performs other duties and special projects as assigned.

Qualifications

• Two years previous medical office experience.
• Ability to do essential duties.
• Ability to read, understand, speak, write and follow English instructions. Bilingual abilities preferred.
• Ability to speak clearly and concisely for effective communication.
• Superior knowledge of authorization/verification process.
• Knowledge of Nevada insurances.

• Ability to use excellent communications skills.
• Ability to manage stress appropriately.
• Ability to manage time efficiently.
• Ability to handle multiple projects and prioritizes effectively.
• Ability to work alone and/or with others effectively.
• Ability to work in close proximity to others in a distracting environment.
• Possesses common sense understanding to carry out instructions furnished in written, oral and diagram form.

Physical Demands:

• Standing -This position occasionally requires standing to scan, fax and copy job related documents to carry out job duties.
• Walking - This position frequently requires walking short distances of up to 100 yards to communicate with patients, staff, doctors, vendors, and direct report.
• Sitting - This position consistently requires sitting for a majority of the day to complete essential job duties on the computer and telephone.
• Lifting - This position occasionally requires lifting objects weighing up to 20 lbs. for short distances to carry out essential job related duties.
• Carrying - This position occasionally requires carrying objects weighing up to 20 lbs. for short distances to carry out essential job related duties.
• Pushing
• Pulling
• Reaching - This position consistently requires reaching with hands and arms less than 2 feet in all directions for items necessary to complete job duties (i.e. stapler, paper clips, phone, keyboard, calculator)
• Handing - This position frequently requires handing paper, clipboards or objects to patients, staff, doctors, and vendors to carry out essential job duties.
• Climbing
• Balancing
• Bending - This position occasionally requires bending/leaning from the waist in all directions to carry out essential job duties.
• Stooping
• Kneeling - This position rarely requires kneeling to assist with possible computer issues.
• Crouching
• Crawling
• Speaking - This position consistently requires verbal abilities to effectively communicate with patients, coworkers, doctors, and vendors on a daily basis to reach optimal work outcomes of the position.
• Hearing - This position consistently requires auditory abilities to efficiently listen and effectively communicate with doctors, vendors, co-workers, and staff to carry out essential job duties.\
• Seeing - This position consistently requires acute visual abilities to enter patient data in the RIS system, document information for the patient’s electronic chart and read patient related documents, authorization forms, insurance verification documentation, insurance cards, physician requests, and other job related paperwork to carry out essential job duties.
• Depth Perception
• Color Vision

Is this position closely, moderately or minimally supervised? Closely
Explanation: This position is closely monitored by the Lead Admin.

Does this position have supervisory responsibility (i.e. responsible for hiring, firing, performance appraisals, etc.)? No

Does this position have access to confidential information? Yes
Explanation: This position has access to protected health information as identified by HIPAA.

Does this position have access to or handle company funds? Yes
Explanation: This position has access to limited company funds of co-pays and deductibles collected at the front desk. These payments are collected in cash, check or credit card on a daily basis from patients seen at the facility.

Is it important to this position the incumbent be able to read, write and communicate fluently in English? Yes
Explanation: A majority of affiliated personnel and patients communicate with our facilities in English. Bilingual abilities are preferred.

What kind of work experience (including length of time), training, and/or level of education is necessary for this position? This position requires a minimum of two years of previous medical office experience, radiology is preferred.
Previous experience in scheduling, medical records and authorizations is required. Knowledge of Nevada insurance carriers is preferred.

List any technical skills (typing, computer skills, etc.): The skills required by this position include, but are not limited to, typing, computer literacy, faxing, scanning, copying, and knowledge of data entry on a RIS system.

What other special training and/or abilities are necessary to qualify for this position? The Administrative Staff II must possess skills, aptitudes, and abilities to perform each essential job duty proficiently. They must be able to read, write and interpret reports and correspondence. The individual must have excellent oral and written communication skills needed for daily communication with patients, staff, vendors, doctors, direct report and billing company and medical carriers. Effective interpersonal skills are required for a successful work environment.

Working Conditions
Are there particular working conditions associated with this position that should be noted (i.e., working environment, hours of work, travel, work space, etc.)? Yes or No
Explanation: The working environment is in a medical office setting that can be moderately loud at times. This position will carry out his/her duties in an average sized workspace. The hours of work may vary, but are approximately 8:00 a.m. to 5:00 p.m. This position may require traveling to all Company facilities. Overtime and weekend work may be required.