Authorization Specialist Sr

This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribes and triages patient calls to physicians, coordinates patient appointments/orders. Provides support to all other Authorization Specialists and act as the unit's primary liaison to other areas. 

Required:

High School diploma

License

• Medical Assistant or LPN training

Work Experience and Additional Information 

• 5 years of relevant medical office experience to include auth/pre-cert
• Knowledge of medical terminology, CPT & ICD-9 coding
• Excellent communication skills

Duties & Responsibilities
• Obtains relevant information to initiate & coordinate the authorization/pre-certification process between the referring physician, insurance carrier, and organization for timely scheduling
• Develops working relationships and recommends procedures between the referring physician, the organization, the insurance carrier and other agencies for continuity of care
• Assists and educates patients through the process to provide a positive patient experience 
• Maintain the patient's EMR by entering detailed notes related to the procedure, benefits, and authorization for a complete & accurate record
• Responsible for compiling relevant information and documents for peer-to-peer reviews for timely resolution