Hospital Authorization Specialist II

This is a fully remote position, open to applicants in Alabama, +15 more locations.

📋 Description

• Secure authorizations for scheduled services at hospitals and physician appointments.

• Initiate authorizations, track follow-ups, monitor additions, and update authorizations as needed.

• Complete authorizations in accordance with departmental guidelines and payer specifications.

• Utilize available resources to finalize authorization requests and confirm eligibility.

• Interpret benefits to generate estimates and clearly explain information to patients and their families.

• Ensure that requests for authorizations and notifications are conducted promptly and documented accurately.

• Review appointment additions, service modifications, date alterations, and patient classification changes.

• Adhere to administrative review protocols for cases that lack authorization within designated timeframes.

• Examine clinical documentation and submit necessary information to payers.

• Document interactions with payers, physicians, and families.

• Collaborate with various departments including business, finance, transport, cost estimation, managed care, utilization review, and physician authorization.

• Engage in daily departmental meetings and report issues related to payers, workflow obstacles, and risks to reimbursement or service delivery.

• Develop and sustain professional relationships with specialty departments.

• Assist in training on newly implemented processes.

⛳️ Requirements

• Experience in authorizations is required.

• A High School Diploma is mandatory.

• 1-3 years of related job experience is necessary.

• Certification related to Revenue Cycle (e.g., CRCR) is preferred.

• Candidates must reside in Alabama, Colorado, Delaware, the District of Columbia, Florida, Georgia, Illinois, Maryland, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or Virginia.

• Capability to request and secure preauthorization for assigned specialties and manage other specialties, work queues, preadmissions, and estimates.

• Ability to interpret benefits and verify eligibility, demographic details, insurance coverage, and financial responsibilities.

• Proficient in reviewing clinical documentation and payer clinical guidelines.

• Skillful in utilizing payer tools to ascertain authorization requirements.

• Competent in documenting communications in line with standardized criteria.

• Strong written and verbal communication skills.

• Ability to function effectively in a virtual team setting, solve problems, maintain organization, and seek help when necessary.

• Commitment to providing outstanding and empathetic customer service.

🏝️ Benefits

• Competitive salary.

• Comprehensive health and wellness benefits.

• Opportunities for professional development and training.

• Supportive work environment focused on teamwork.