Patient Services Coordinator IV (Authorization Specialist) - Plastics & Reconstructive Surgery Asheville

Patient Services Coordinator IV (Authorization Specialist)

Novant Health Plastics & Reconstructive Surgery - Asheville

1815 Hendersonville Rd Ste 104, Asheville, NC 28803

Schedule: Monday-Friday, 8:00am-5:00pm

Novant Health Plastics & Reconstructive Surgery is seeking a highly organized and detail-oriented Patient Services Coordinator IV (Authorization Specialist) to support our patients, providers, and clinical team. This role serves as the primary resource for obtaining insurance authorizations and ensuring timely approval of specialty procedures, surgeries, treatments, and diagnostic services. The ideal candidate will have a strong understanding of insurance requirements, excellent communication skills, and a commitment to delivering an exceptional patient experience.

• Education: High School Diploma or GED, required.
• Experience: Three years of experience in a medical office setting, required.
  • Other related experience may be considered in lieu of medical office experience.
• Additional Skills (required): Knowledge of medical office software for the following: updating patient demographic information, posting charges, copays, and scheduling patient appointments. Requires understanding of CPT and ICD9-CM coding processes. Requires excellent verbal communication skills. Must be able to work with changing priorities. Requires excellent organizational, problem solving and critical thinking skills. Must be able to interact with individuals of all cultures and levels of authority. Requires the ability to maintain confidentiality. Must be able to function as part of a team. Must possess initiative. Basic medical terminology required, knowledge can be obtained through formal classes or work experience. High level of working knowledge of EPIC systems. Detailed knowledge of multiple payors billing requirements. Familiarity of coding requirements for practice specialty.
• Additional Skills (preferred): Proficient in the use of all computer software utilized in the practice.

• Serve as the primary authorization specialist for surgical procedures, reconstructive services, imaging, medications, and other specialty treatments.
• Verify insurance benefits, eligibility, and authorization requirements prior to services being rendered.
• Obtain, submit, track, and document prior authorizations with insurance carriers in a timely and accurate manner.
• Communicate authorization requirements, status updates, and insurance guidelines to patients, providers, and clinical staff.
• Collaborate with physicians, surgical schedulers, and clinical teams to ensure all required documentation is submitted for approval.
• Monitor authorization work queues and follow up on pending requests to prevent delays in patient care.
• Resolve authorization denials by gathering supporting documentation and coordinating appeals when appropriate.
• Maintain accurate records within Epic and other designated systems.
• Function as a department resource and may provide support with Epic workflows, miscellaneous work queues, and other advanced practice operations functions.
• Ensure compliance with payer guidelines, regulatory requirements, and organizational policies.