Authorization Specialist

Loeye; Grand Ledge, Northern (MI, KY); Hybrid; USD 25,000 - 29,000; Full time

Job summary

L.O. Eye Care in Grand Ledge, MI is seeking an Authorization Specialist to secure pre-authorizations, verify insurance, and communicate with providers, patients, and payers.

The role requires 3–5 years of health-care billing experience, HIPAA knowledge, and familiarity with NextGen; a work-from-home option and a typical office environment are offered.

Qualifications

• High School Diploma or GED required.
• 3–5 years’ experience in health-care (billing or clinical).
• Experience working with medical payers and vision insurance.
• HIPAA regulations knowledge.
• Working knowledge of CPT and ICD-9 & ICD-10 coding.

Responsibilities

• Verify patient’s insurance eligibility, benefits and requirements with carriers.
• Request, track and obtain pre-authorization within time allotted for services.
• Request and secure prior-authorizations before services are performed.
• Communicate insurance changes or trends among team.
• Maintain productivity suitable for the department.
• Document all communications and contacts in standardized records.
• Attend meetings and training; comply with regulations and procedures for collecting payments.
• Perform other duties as assigned.

Skills

Communication

Conscientiousness

Teamwork

Adaptability

Trustworthy

Patient confidentiality

Education

High School Diploma or GED

Tools

NextGen

Job description

# Authorization SpecialistHot JobGrand Ledge, MI 48837## OverviewSalary Range$18.00 - $21.00 HourlyLevelExperiencedPosition TypeFull TimeJob ShiftDayEducation LevelHigh SchoolCategoryAdmin - Clerical## Description**Summary** The Authorization Specialist, a key position in the Revenue Cycle, obtain authorizations/reauthorizes all procedures, surgeries, and medications/injectable. This position requires excellent follow-up and correspondence with external sources such as hospital/surgery centers, providers, patients, and insurance inquiries/correspondence.**Supervisory responsibilities** This role has no supervisory responsibilities.**Essential functions***The following list is a summary of the key functions of the job and may not be inclusive of all duties assigned*.* Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.* Request, track and obtain pre-authorization from insurance carriers within time allotted for services.* Request, follow up and secure prior-authorizations prior to services being performed.* Communicate any insurance changes or trends among team.* Maintains a level of productivity suitable for the department.* Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.* Attend and participate in meetings and training* Complying with rules, regulations, policies, and procedures for collecting payments.* Performing other duties as assigned. **Core Competencies**All employees of L.O. Eye Care are expected to demonstrate the following core competencies, regardless of position or status. Additional job-specific competencies may be required of each position.* Communication – Ability to communicate effectively both verbally and in writing.* Conscientious – Ability to feel obligated to do right or be good along with awareness of one’s own conduct, intentions, or character.* Teamwork – Ability to work well in groups, develop and maintain positive working relationships, help resolve conflict, and support team goals.* Adaptability – Ability to adapt to change, be open to new ideas, handle pressure and uncertainty, and adjust work plans to meet changing company needs.* Trustworthy – Ability to be worthy of confidence and create assured reliance on the character, ability, and truth of own self.* Patient Confidentiality – Ability to maintain patient confidentiality, and hold others accountable to such, in accordance with the highest ethical standards.**Other duties**Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. **Work environment*** Work from home and/or typical office environment.**Physical demands/potential hazards*** Must be able to sit for prolonged periods, must be able to use eyes, hands, and body to maintain office dexterity and mobility; may be required to lift typical office equipment up to 20 pounds.**Travel required*** 0-25% travel required.## Qualifications# Education and experience*Educational requirements that are job-related and consistent with business necessity** High School Diploma or G.E.D. required.* Previous medical billing experience with knowledge of billing related reporting.* Three to five years’ experience in health-care (billing or clinical).* Experience working with medical payers and vision insurance.* Demonstrated knowledge of medical terminology with high proficiency in general medical office procedures including HIPAA regulations.* Working knowledge of medical billing systems, Nextgen a plus.* Working knowledge of CPT and ICD-9 & ICD-10 coding system.# Leadership and management experience*Leadership requirements that are job-related and consistent with business necessity* N/A**Additional eligibility requirements** **Work authorization/security clearance requirements**Must be authorized to work in the US