What are the responsibilities and job description for the Authorization Specialist Healthcare position at Winston Resource LLC?
Hybrid role, 1 years related experience, top Gastro practice, Temp to hire or direct hire for experienced candidates, open to both
- Obtain pre-authorizations for gastro procedures (colonoscopy, endoscopy, ERCP, capsules, etc.) – they will need to understand CPT and ICD codes.
- Must have a comprehensive knowledge of insurance carrier policies and procedures – insurance will often provide incorrect / misinformation (such as no authorization required). They must have the knowledge to push back and question what they’re told
- Our company policy is they must be two weeks ahead of the scheduled procedures as authorization requests can be delayed / take longer than expected – this requires speed.
- Eligibility verification for all patients being seen each day using various portals – our EMR (ECW), Navinet, Availity, E-tactics, etc.
- We are a very busy practice – they need to have an element of speed to keep up with the eligibility and authorization requests
- The ability to comprehend and explain patient benefits – deductibles, coinsurance, copays, any patient responsibility
- They will be calling patients to explain these benefits prior to their procedures – they need to have customer service skills and be able to explain and answer questions regarding patient benefits / financial responsibility
- The ability to effectively communicate with providers, staff, and patients – both written and oral. They will be sending many emails to providers and staff regarding authorization requests, they are also communicating with patients regularly. They will be a representation to both our physicians and patients and must present themselves professionally.
Medical 401k and PTO
