Authorization Specialist

American Vision Partners; Phoenix (AZ); On-site; USD 30,000 - 42,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Eye care discounts

Child care assistance

Pet insurance

Continuing education funds

401(k)

Paid holidays

PTO

Sick time

Sign-on bonus available

Job summary

American Vision Partners (AVP) is seeking an Insurance Verification Specialist to join our Phoenix team. This role focuses on verifying coverage, obtaining benefits, and securing prior authorizations for services at our Phoenix Corporate Office.

You will collaborate with clinics, patients, and payers, accurately calculate patient responsibility, update records, and maintain HIPAA compliance. Daily duties include communications, handling requests, and upholding productivity standards in a

Qualifications

• High School diploma or equivalent.
• Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience.

Responsibilities

• Verify insurance coverage and obtain benefits information.
• Obtain prior authorization for services.
• Process requests for prior authorization for surgery or procedure injections.
• Identify and resolve problems with participant eligibility/insurance coverage.
• Calculate patient responsibility amounts based on benefit information.
• Document findings thoroughly and accurately.
• Prioritize work to maximize turn-around time.
• Meet or exceed productivity standards in daily assignments.
• Maintain an acceptable error rate per policy.
• Update demographic information to produce clean patient statements.
• Answer calls and respond to emails in a timely manner.
• Perform other assigned duties.

Skills

CMS guidelines

Computer literacy

Attention to detail

Reading instructions

Math skills

Critical thinking

Teamwork

Customer service

Self-discipline

HIPAA compliance

Education

High School diploma or equivalent

Job description

Company Intro

At American Vision Partners (AVP), we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas – including 25 ambulatory surgical centers.At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees!

Overview

This position verifies insurance coverage, benefits and obtains prior authorization for services.

$1,000 sign-on bonus available (terms apply)

Bonus paid after 90 days; repayment required if employment ends within 6 months.

This role is based exclusively at our Phoenix Corporate Office in the Biltmore area and requires daily onsite attendance - This is not a remote or hybrid position.

Responsibilities

MAIN:

• Contacts insurance plans to determine eligibility and obtain coverage and benefit information.
• Obtains prior authorization for services.
• Processes requests for prior authorization for surgery and/or procedure injections
• Identifies and resolves problems with participant eligibility/insurance coverage
• Accurately calculates patient responsibility amounts based on benefit information and payer allowable.
• Documents findings thoroughly and accurately.
• Prioritizes work to maximize turn-around time.
• Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
• Maintain an error rate in accordance with departmental policy.
• Makes changes to demographic information as necessary in order to produce a clean patient statement.
• Answer and respond to external and internal phone calls in a timely manner.
• Check and respond to emails in a timely and professional manner.
• Performs all other assigned duties.

GENERAL DUTIES:

• Conducts self in accordance with the company’s standard values and policies.
• Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels.

The Essential Job Functions and Duties and Responsibilities listed above are not exhaustive. The job functions and duties of this job may vary depending upon the specific nature and needs of the department, including size, location and services offered. At some locations, employees may not perform all of the job functions or duties listed above. At other locations, employees may perform some or all of the job functions or duties listed above and, in addition, may be required to perform other job functions or duties as directed. In addition, given the nature of its business, MMRG retains the right to modify the essential job functions and duties of this position at any time.

METHOD AND FREQUENCY OF SUPERVISION:

• Monthly meetings with supervisor. Informal supervision with employee through an open door policy. Employee is expected to ask questions when needed.

The expected pay for this role is up to $26 per hour. Final compensation will be based on factors such as relevant experience, skills, internal equity, and market data.

Qualifications

Education:

• High School diploma or equivalent

Prior Experience:

• Minimum of 1-2 years of insurance verification, referrals, prior authorization, or eligibility experience required experience preferred.

Skills and Proficiencies:

• Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
• Demonstrated computer literacy
• Well-organized with attention to detail
• Ability to read and understand oral and written instructions
• Excellent math skills
• Critical thinking skills are strongly preferred
• Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
• Professional customer service skills.
• Have a desire and dedication to work with self-discipline.
• Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Physical Abilities:

• Ability to sit for long periods. Work requires walking, bending, standing, sitting, and reaching

Benefits & Perks

Your health, happiness and your future matters! At AVP, we offer everything from medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays, PTO, Sick Time, opportunity for growth, and much more!