Authorization Specialist I, RCM

The Authorization Specialist is a position that performs the authorization requests for all insurances. This employee reports directly to the Authorization Manager, RCM.

• →

  Checking eligibility/benefits on patients as needed: Upon intake if not previously done for all patients and monthly on patients with non-Medicaid insurances and the beginning of each month where prior authorization is not required

• →

  At the beginning of every new year, obtaining details on eligibility, patients deductible and out of pocket costs

• →

  Communicating any patients that will have a patient responsibility with the appropriate staff so they can verify the patient will want services and to inform field staff to correctly fill out the consents

• →

  Tracking and obtaining all authorizations for all locations, along with reauthorization throughout duration of patient care

• →

  Data entering all authorization information into the system

• →

  Verifying accuracy in payor setup in EMR for all active policies

• →

  Maintain electronic record of all authorizations

• →

  Run reports daily, weekly, and monthly for department

• →

  Communicate with both internal and external customers to ensure authorizations are utilized accurately

• →

  Performs other duties as assigned

• Excellent verbal and written communication skills with ability to communicate across all levels of field-based leadership

• Demonstrates high degree of organization and problem solving

• Able to effectively deal with change

• Able to complete projects and tasks within specific timetables

• Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner

• Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information

• Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations

• Requires the ability to interpret, adapt and react calmly under stressful conditions

• Must be able to relate cooperatively and constructively with clients and co-workers

• High School Diploma or Equivalent

“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job.  However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.”

• Requires the ability to write, dictate or use a keyboard to communicate directives

• Utilizes proper body mechanics in multiple environments

• Requires the ability to function in multiple environments

FLSA Status: Non-exempt

EEO Status:  Administrative Support Worker