What are the responsibilities and job description for the Auth/Claim Specialist position at Transformation Healthcare?
Job Description
Job Description
Description :
We are looking for an Authorization Specialist to join our Claims / Billing Department. In this role, you complete authorizations and referrals for our mental and substance use services. In addition to reviewing the medical history of potential patients, you verify information provided by their referring physicians and verify their insurance coverage. You also monitor the schedule for our add-on patients, ensuring there are no conflicts and that we have the prior authorization we need to move forward with their appointment or procedure. While we prefer candidates who have an associate degree in medical coding or a related field, we will consider anyone with experience in medical billing or insurance authorization.
Requirements :
Duties and Responsibilities
- Complete authorizations and referrals for services, including appointments and procedures
- Review patient's medical history and insurance coverage for approval
- Check for eligibility, copays and deductibles
- Contact referring physicians for additional information as needed
- Input new patient information and update information in our system
- Monitor schedule for potential issues
- Complete billing documentation
- Scrub, fix and resubmit denied claims
- Complete manual and auto posting to balance patient's account
- Assist with other clerical tasks as needed
Requirements and Qualifications