Authorization Specialist

Option Care; Boston (MA); On-site; USD 27,000 - 45,000; Full time

Benefits offered by this job

Medical, Dental, & Vision Insurance

Paid Time off

401K Retirement Savings Plan with Cmpy

HSA Company Match

Flexible Spending Accounts

Tuition Reimbursement

myFlexPay

Family Support

Mental Health Services

Company Paid Life Insurance

Award/Recognition Programs

Job summary

Option Care Health is seeking an Authorization Specialist to submit insurance authorizations, set up patient accounts, and verify medical necessity. You will communicate with providers, review documents, and ensure compliance with payer requirements in a fast-paced environment.

The role emphasizes accuracy, attention to detail, and coordination with billing to resolve authorization issues. A high school diploma is required, with healthcare billing experience preferred.

Qualifications

• High school diploma or equivalent is required.
• Ability to multi-task and support numerous referrals/priorities at one time.
• Ability to work in a fast past environment.
• Must be detail-oriented and have a high degree of quality focus.

Responsibilities

• Submit accurate and timely authorization requests to insurance companies and payers.
• Ensure proper setup and maintenance of patient accounts in the system.
• Obtain and review clinical documentation to verify medical necessity.
• Communicate with healthcare providers to gather required information for authorizations.
• Verify insurance benefits and eligibility for services.
• Monitor the status of authorization requests and follow up as needed.
• Ensure compliance with payer requirements and regulations.
• Utilize basic medical coding, diagnosis codes, and medical terminology in the authorization process.
• Maintain detailed records and documentation for all authorizations.
• Collaborate with billing and claims teams to resolve any authorization-related issues.

Skills

Multi-tasking

Fast-paced

Detail-oriented

Time management

Education

High school diploma

Job description

Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members. Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Job Description Summary: Job Description:

Job Responsibilities (listed in order of importance and/or time spent)

• Submit accurate and timely authorization requests to insurance companies and payers
• Ensure proper setup and maintenance of patient accounts in the system
• Obtain and review clinical documentation to verify medical necessity
• Communicate with healthcare providers to gather required information for authorizations
• Verify insurance benefits and eligibility for services
• Monitor the status of authorization requests and follow up as needed
• Ensure compliance with payer requirements and regulations
• Utilize basic medical coding, diagnosis codes, and medical terminology in the authorization process
• Maintain detailed records and documentation for all authorizations
• Collaborate with billing and claims teams to resolve any authorization-related issues

Supervisory Responsibilities

Does this position have supervisory responsibilities? (i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.) No X

Basic Education and/or Experience Requirements

High school diploma or equivalent is required.

Basic Qualifications

• Ability to multi-task and support numerous referrals/priorities at one time.
• Ability to work in a fast past environment.
• High degree of self-discipline in maintaining productivity expectations.
• Must be detail-oriented and have a high degree of quality focus.

Travel Requirements: (if required)

N/A

Preferred Qualifications & Interests (PQIs)

Healthcare/medical billing experience preferred.

This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties May perform other duties as assigned

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $19.57-$32.63

Benefits

• Medical, Dental, & Vision Insurance
• Paid Time off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.

For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.