Authorization Specialist

CommonSpirit Health; Woodland (CA); On-site; USD 38,000 - 43,000; Full time

Job summary

Dignity Health Medical Foundation in California seeks an Authorization Specialist to verify and update patient demographics and insurance data, and to pre-authorize coverage for procedures. You will schedule and manage appointments using IDX, while ensuring high-quality patient service.

You will obtain authorizations, interact with provider staff, screen for ABN when needed, and support billing to maximize reimbursement. Strong attention to detail and confidentiality are essential.

Qualifications

• Must read, write and speak English and type at least 35 wpm.
• Experience with clerical tasks and aptitude testing.
• Familiarity with Windows-based systems and business communications.

Responsibilities

• Verify and update patient demographics and insurance data in EMR/practice systems.
• Schedule, cancel, reschedule and coordinate patient appointments using IDX.
• Obtain internal/external prior authorizations and coordinate with staff.
• Interface with provider office staff for authorization information.
• Perform Advanced Beneficiary Notice screening for referrals to other departments.
• Collaborate with billing to maximize reimbursement through appeals.
• Maintain accurate records and update demographics/insurance as needed.

Skills

English language skills

Typing speed 35 wpm

Clerical aptitude

Aptitude testing

Confidential data handling

Customer service orientation

Windows OS familiarity

Insurance carrier knowledge

Independent work

Time management

Education

High School Diploma or GED

Job description

Job Summary and Responsibilities

As our Authorization Specialist, you will provide support to physician offices through verification and update of patient demographics and insurance data. This is an SEIU-UHW represented position.

Every day, you will schedule, cancel, reschedule, and coordinate patient appointments using the IDX system. You will also collect patient data, as required, and verify and pre-authorize insurance coverage for procedures and schedule follow-up appointments.

To be successful, you will have strong detailed-orientation and communication skills to provide superior customer service to our patients.

• Keep accurate records in the EMR and/or practice management system as well as any manual filing systems.
• Obtain internal and external prior authorizations for all insurance carriers using carrier specific tools and/or methods and schedule patient appointments communicating with patient and provider/nursing staff as necessary.
• Interface with provider office staff for the purpose of attaining additional information required for authorization approval.
• Advanced Beneficiary Notice Screening as necessary for services referred to other departments such as cardio-pulmonary lab, radiology, gastroenterology, etc.
• Collaborate with billing staff to maximize reimbursement through claims appeals.
• Update patient demographics and/or insurance as needed.

Job Requirements

• High School Diploma or GED
• General computer experience required
• Has the ability to read, write and speak English in order to perform duties of the position, as well as the ability to type a minimum of 35 words per minute, pass a clerical and ten key tests as well as a pre- employment aptitude test
• Fundamentals of business communications, Windows based computer operating system
• Ability to: Apply good judgement in a variety of confidential and sensitive situations
• Required knowledge of a variety of insurance carrier protocols as demonstrated through successful completion of the aptitude test
• Communicate and interact effectively with internal and external customers
• Work independently with minimum supervision, using time wisely
• Take instruction and follow established procedures
• Work under conditions that are every changing with frequent interruptions, and flexible hours
• Maintain timely, accurate, legible, and complete records

Preferred

• At least one-year recent experience in a medical office practice, including business and scheduling functions preferred
• Knowledge of Medical terminology preferred

Where You'll Work

Dignity Health Medical Foundation established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California , Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.

One Community. One Mission. One California

Pay Range

$27.50 - $31.23 /hour