Seeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 15 physicians and 6 clinic locations. DUTIES INCLUDE, BUT ARE NOT LIMITED TO:Interpret insurance benefits and calculate patient responsibilityReview chart documentation to ensure patient meets medical policy guidelines Prioritize incoming authorization requests according to urgency Obtain authorizations via payer portals or by phone and follow up regularly on pending cases Initiate appeals for denied authorizations Respond to clinic questions regarding payer medical policy guidelines Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order Contact patients to discuss authorization status Other duties as assignedQualifications:Knowledge of commercial and governmental insurance plans (HMO, PPO, EPO, etc.) and payer portalsKnowledge of NextGen EHR software (preferred)MS Office, basic office support skills (telephone, filing, data entry) and basic math skills.Excellent telephone etiquette, pleasant personality and customer service skills.Ability to multitask and remain focused while managing a high-volume, time-sensitive workload Plans and prioritizes to meet deadlinesEXPERIENCE: Previous experience in a similar role required.2 years medical prior authorization and verification experience required 2 years' experience in a medical related field requiredHigh school diploma or GED requiredJob Type: Full-time - Monday through Friday with a few rotating Saturday mornings. Traveling involved from one clinic to another based on schedule. Dependable transportation required.Great benefits: Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life Insurance and 401K.Job Type: Full-timeBenefits:401(k)Dental insuranceHealth insuranceLife insurancePaid time offVision insuranceMedical Specialty:Medical-SurgicalSchedule:8 hour shiftDay shiftMonday to FridayWeekend availabilityEducation:High school or equivalent (Required)
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