Communication Skills, Detail Oriented, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Insurance, Managed Care, Medical Office, Medical Records, Medical Terminology, Medical Treatment, Operational Support, Organizational Skills, Patient Care, Patient Confidentiality, Presentation/Verbal Skills, Process Development, Record Keeping, Regulations, Regulatory Compliance, Writing Skills
LOCATION
Plano, Texas
POSTED
14 days ago
About the role
We are seeking an Insurance Authorization Specialist to join our team. The ideal candidate will play a part of the patient’s experience and assist in facilitating when the physician determines that the patient is a candidate for surgery. The Authorization Specialist works with the scheduling coordinators and insurance carriers to obtain authorization, coordinate peer-to-peer calls, generate and collect surgery estimates, plus any additional steps needed for their procedure.
What you'll do
Manage and maintain accurate medical records in compliance with HIPAA regulations.
Perform insurance verification to ensure coverage and eligibility for services provided.
Collaborate with managed care organizations to facilitate patient care and streamline processes.
Verify insurance coverage and precertification for patient appointments including copay, deductible, and co-insurance
Determine patient fee responsibility electronically and/or by phone
Update insurance information for existing patients
Communicate effectively with patients, providers, and insurance companies regarding medical terminology and procedures.
Maintain organized office operations to support the overall efficiency of the medical practice.
Navigate insurance carrier portals
Outbound pre-certification calls
Detail and ability to multi-task
Maintain the daily worklist through applicable applications
Maintain the daily surgery denial worklist
Qualifications
Knowledge of HIPAA regulations and commitment to patient confidentiality.
Experience with insurance verification processes and managed care systems.
Familiarity with medical terminology and record management systems.
Strong organizational skills with attention to detail in a fast-paced environment.
Excellent communication skills, both written and verbal, to interact effectively with patients and healthcare professionals.
Previous experience in a medical office or related field is a plus but not required.
Join us in making a difference in patient care through your expertise as a Specialist!