Authorization Specialist

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Conduct patient registration, scheduling, and verifying insurance details.

• Respond to patient phone calls and manage routine inquiries related to online and in-office scheduling.

• Arrange, modify, and update patient appointments as needed.

• Gather demographic information from patients and assess their eligibility.

• Collect co-payments and deductibles from patients.

• Contact insurance providers to confirm eligibility, benefits, and requirements.

• Request, track, and obtain pre-authorization for medical and therapy services within specified timeframes.

• Process insurance authorizations and maintain updated patient records.

• Research referrals for approval or denial and identify diagnoses using CPT and ICD-10 coding.

• Utilize online insurance verification platforms.

• Communicate any changes or trends in insurance to the team.

• Address patient inquiries and scheduling requests promptly.

• Engage in performance improvement initiatives and orientation activities.

• Document communications and interactions in accordance with standardized protocols.

• Provide education to patients and colleagues regarding preauthorization and coverage information.

• Employ scheduling, EMR, and other software tools to effectively understand and communicate patient needs.

• Report necessary information and any unusual occurrences following established policies and procedures.

• Ensure adherence to regulatory and CAO guidelines, policies, and procedures.

• Execute other assigned responsibilities as required.

⛳️ Requirements

• High School Diploma or equivalent qualification.

• Strong understanding of medical terminology.

• Above-average spelling and typing abilities.

• Competence in computer software, including online insurance platforms and DASH.

• Proficient in the Microsoft Office suite of applications.

• Experience in collaborating across various functions.

• Background in innovating within a fast-paced work environment and managing ambiguity.

• Excellent interpersonal, verbal, and written communication skills.

• Capability to organize, prioritize, and handle multiple tasks in a dynamic setting.

• Ability to work autonomously.

• Strong time management, organizational, and administrative support skills.

• Must be able to read, write, speak, understand, and communicate effectively in English.

• Must be able to remain seated for extended periods and lift weights up to 25 pounds.

• Must be capable of frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.

• Adequate hearing and visual acuity to fulfill job duties effectively.

• Must be able to communicate clearly with patients both in person and over the phone.

🏝️ Benefits

• Full-time employment opportunities.

• Option for remote work.