What are the responsibilities and job description for the Authorization Specialist position at Restore First Health?
At Restore First Health, we are dedicated to providing advanced, in-home wound care through a holistic approach that emphasizes collaboration, communication, and care coordination. Our mission is to improve health outcomes by delivering innovative, patient-centered care.
Position Overview:
The Authorization Specialist reviews insurance information and determines if any authorization or official confirmation is necessary before providing the medical services. The Authorization Specialist will also perform prior authorization responsibilities, which entail determining if the insurance company covers a given procedure or service. Additional duties are to compile paperwork related to the patient, assess their eligibility for services that Restore First Health provides its patients, communicate with the insurance provider, and track the progress of all referrals that require prior authorization.
Key Responsibilities:
Procedure Scheduling:
Schedule visits for the medical practice and provide schedule information to physicians and advanced practitioners and staff within 24 hours of the next business day.
Must schedule office visits according to established protocols.
Provide patients with written and verbal preparatory instructions for procedures that are
Ordered. Must have knowledge of preparation for all office services provided.
Provide staff and providers with schedule copies for the next office business day.
Responsive to all phone calls in an a
Assures chart completion prior to admission:
Assure proper history and physician exam, indication for testing and all other pertinent clinical information is present in the chart prior to patient arrival.
Assure precertification numbers are obtained prior to patient arrival.
Assure physician and referral information are complete prior to patient arrival.
Other duties:
Maintains knowledge regarding different insurance providers and their requirements for medical necessity and reimbursements to obtain appropriate VOB and pre-certifications.
Maintains knowledge of diagnostic codes related to Prime Regen business lines.
Performs precertification if needed.
Takes ownership of service recovery issues and works to be a patient advocate.
Fax study results and other requests to appropriate physicians and provide PI data for turnaround times.
Provide medical records upon request.
Education and Experience:
High school diploma or equivalent
Two years front office experience or equivalent, prefer medical office scheduling.
Required Skills/Abilities:
Knowledge of basic office skills and operation of office equipment including but not limited to typing, copier, fax machine, computer and computer software (ie, Microsoft Office). Minimum typing skills of 35 wpm.
Interpersonal skills, customer service skills, and a positive attitude required.
Must communicate and understand verbal and written English language.
Requires knowledge and understanding of multiple in office departments.
Analytical ability sufficient for determining scheduling times and coordination of technical schedule.
Must have knowledge of medical terminology.
Our Culture and Values:
At Restore First Health, we believe that exceptional patient care starts with a strong, compassionate team. Our values emphasize:- Collaboration: Working closely with healthcare professionals, home health agencies, and skilled nursing facilities to ensure seamless wound care delivery.
- Care Coordination: Partnering with physicians, specialists, and home care providers to optimize patient outcomes.
By joining Restore First Health, you will be part of an innovative, patient-focused team dedicated to improving lives through advanced wound care.
- Communication: Prioritizing real-time updates and clear documentation to align all members of the care team.
Salary : $18 - $23
