What are the responsibilities and job description for the Authorization Specialist position at Redeem Health Care Medical Systems?
Financial Counselor
Specific Duties & Responsibilities
Manages all administrative (non-clinical) aspects of the patient encounter. This includes accurate data entry on each patient to facilitate the patient encounter, expediting the check-in / check-out procedure.
Coordinate pre-registration by completing financial clearance for scheduled and non-scheduled patient appointments. The financial clearance process includes but is not limited to insurance verification, obtaining referrals and authorizations (when applicable), communicating pertinent information to the patient and referring physician that may or may not have a financial impact on requested services in addition to documenting all appropriate systems as for outpatient services rendered.
Serve as a liaison between the clinic, insurance company and patient to ensure all services are financially cleared prior to the date of service to enable prompt access to appropriate clinical services. Effectively use budget resources within control.
Inform supervisor and/or team lead of supply needs.
Confide with team lead or supervisor prior to making decisions based on established policies, procedures, and protocols.
Read and understand requisitions, referral and insurance forms, patient related data and other forms. Read and understand all screens related to insurance.
Read and understand departmental protocols. Read and understand written product directions.
Use information in protocols to fulfill duties effectively and responsibly and complete simple reports.
Perform other duties as required.
- Greets each patient in a kind and professional manner.
- Collects identification and insurance cards and scans into system.
- Assist client to obtain insurance and identification cards.
- Works collaboratively with others.
- Manages patient check – in including verification and entering of insurance information, and patient demographic information into Methasoft
- Assist client to obtain Uninsured Grants if eligible.
- Assist client to obtain MD Medicaid/ Medicare when necessary.
- Confirms all needed forms are up to date, and signed HIPPA, consents, Outpatient agreement
- May obtain pre-certification as required by patient’s healthcare insurer or managed care provider.
- Facilitates smooth transfer of patients during their visit within the department or between several departments. Inclusive of correspondence with individual clinic management.
- Maintains familiarity with various types of insurances. Contacts insurance carriers for clarification of coverages to avoid denials of payment.
- Provides support to both clinic Front Desk and billing staff during events of short staffing (sickness, vacation, meetings)
- Collects time of service payment, issue receipts and prepares cash settlement records.
- Guide’s patients and families to appropriate resources.
. Daily end of business day reports to include the following:
- Spreadsheet of Clients serviced and nature of engagement.
- Authorizations secured and expiration.
- Authorizations in process
- Uninsured spans secured and expiration.
This position reports to the Clinic Director & Billing Director, respectively.
Job Type: Full-time
Pay: $19.00 - $222.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- Medical billing: 1 year (Preferred)
- OMHC: 1 year (Preferred)
- substance abuse knowledge: 1 year (Preferred)
- Insurance verification: 2 years (Required)
Ability to Relocate:
- Baltimore, MD 21223: Relocate before starting work (Required)
Work Location: In person
Salary : $19 - $222