Authorization Specialist

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

📋 Description

• Conduct patient registration, appointment scheduling, and insurance verification tasks.

• Professionally and efficiently handle patient phone calls for registration and scheduling purposes.

• Address routine questions regarding online and in-office scheduling.

• Schedule, modify, and update patient appointments as necessary.

• Gather demographic information from patients, assess eligibility, collect co-pays and deductibles, and verify insurance coverage.

• Communicate with insurance carriers to confirm eligibility, benefits, and requirements.

• Request, monitor, and obtain pre-authorizations for medical and therapy services within specified timeframes.

• Process insurance authorizations and update patient records accordingly.

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

• Utilize online insurance verification platforms.

• Share updates on insurance changes or trends with the team.

• Respond to patient inquiries, questions, and scheduling requests promptly.

• Engage in department Performance Improvement initiatives.

• Document communications and provider/personnel interactions in accordance with standardized guidelines.

• Educate patients and colleagues on the preauthorization process and coverage details.

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

• Report essential information and unusual incidents following established policies and procedures.

• Participate in orientation programs for new employees.

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

• Carry out additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent is required.

• Preferred 1–2 years of experience in a medical office setting.

• Strong knowledge of medical terminology is essential.

• Above-average spelling and typing capabilities are necessary.

• Proficient in computer software, including online insurance websites, DASH, and database applications.

• Proficiency in Microsoft Office suite of products is required.

• Experience collaborating across various functions is beneficial.

• Ability to innovate in a rapidly growing work environment and manage ambiguity is important.

• Strong interpersonal skills and the ability to build relationships, collaborate, and influence within a decentralized organization.

• Capability to organize, prioritize, and manage multiple tasks in a dynamic environment.

• Excellent oral and written communication skills with a high level of self-discipline and patience.

• Ability to work independently is essential.

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

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

• Must be able to sit for extended periods and lift up to 25 pounds.

• Must employ appropriate body mechanics techniques while performing desk duties.

• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.

• Adequate hearing is necessary to perform duties in person and over the telephone.

• Must be able to communicate clearly with patients both in person and via telephone.

• Visual acuity must be sufficient to perform job duties, including reading printed materials and computer screens.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Paid time off and holidays.

• Retirement savings plan with employer match.

• Opportunities for professional development and training.

• Supportive work environment with a focus on work-life balance.