Central Authorization Specialist
Location
United States
Posted
17 days ago
Salary
Not specified
No structured requirement data.
Job Description
Job Requirements
- High School or 3 - 5 years related experience and/or training; or equivalent combination of education and experience, required.
- Minimum of 3-5 years of experience in a medical clinic setting or training in a hospital or corporate setting; must be highly computer literate, required.
- Two years of experience related to healthcare insurance verification and/or billing required.
- Approximately two to three years progressively more responsible related work experience necessary in order to gain in-depth understanding of organizational policies, procedures and operations.
- Coding knowledge and knowledge of clinical terminology.
- Understanding of patient treatment plans for purposes of obtaining authorizations.
- Ability to interpret RN or Physician notes in order to facilitate obtaining authorizations.
- Ability to evaluate & communicate to RN/Physician staff additional requirements or roadblocks.
- Additional coursework in business, computers or health care administration, preferred.
- Experience in a medical or surgical specialty clinic, preferred.
- Ability to interpret insurance records and related documentation.
- Current working knowledge of hospital operations, utilization management, case management, and managed care reimbursement, preferred.
- General understanding of revenue cycle with an emphasis on billing, coding, charge capture and reimbursement, preferred.
- Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families if required.
- Strong oral and written communication skills required.
- Strong analytical and data management skills.
- Ability to work with all levels of management.
- Strong interpersonal communication and negotiation skills and experience interacting with clinicians and finance personnel.
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