Authorization Specialist (Cooper Green)

University of Alabama at Birmingham; Birmingham (AL); On-site; USD 21,000 - 31,000; Full time

Job summary

University of Alabama at Birmingham in Birmingham, AL seeks an Authorization Specialist (Cooper Green). The role involves coordinating referrals, verifying patient demographics and insurance, and obtaining precertifications while maintaining strong customer service. Experience in a medical setting is preferred.

The position requires working onsite with the CGMHSA team and handling multiple clinics, ensuring timely processing of authorizations and accurate documentation in NextGen EMR.

Qualifications

• High school diploma or equivalent required.
• One year in a medical practice setting preferred.
• CHAA certification is a plus.

Responsibilities

• Obtains and/or verifies patient demographics & insurance information; updates appointment status in NextGen.
• Schedules patient referrals internally and externally.
• Verifies information on referrals is accurate and complete.
• Obtains precertification through private insurance if applicable.
• Notifies patients if a copayment is required for outside services.
• Verifies enrollment of patients to Cooper Green.
• Verifies insurance benefits.
• Answers phone and takes complete, accurate messages; routes to appropriate person promptly.
• Accurately schedules patient appointments with correct information.
• Assists with reporting as needed.
• Obtains appointment date/time for patients referred outside CGMHSA.
• Ensures information entered into EMR is complete and accurate.
• Other duties as assigned.

Skills

Medical terminology

Customer service

Telephone courtesy

English grammar

PC software

Education

High school diploma or equivalent

College coursework substitute for experience

CHAA certification (preferred)

Tools

NextGen EMR

Precertification software

Job description

Job Description - Authorization Specialist (Cooper Green) (CGM0000P)

Description

STATEMENT OF VALUES:

Cooper Green Mercy strives to be THE choice for health care in our community. We honor this commitment by embracing our core values of:

• Kindness,
• Inclusion,
• Cleanliness, and;
• Attention to Detail.

GENERAL SUMMARY

Under minimal supervision and according to CGMHSA established policies and procedures, provides a variety of specialized services in support of the operations of scheduling personnel and processes within the multiple clinic settings at Cooper Green. This role will comprise of a mix of traditional authorization specialist duties and insurance verification duties. The Authorization Specialist duties may include the assignments of daily reports, handling and troubleshooting day to day issues authorization specialist face, liaising specialty clinics and primary care providers, schedules referrals internally and externally, issue authorization number for services when appropriate, handles verification and precertification’s for insurance benefits and communicate with patients about patient specific referrals. Consistently demonstrates outstanding customer service to CGMHSA patients, visitors, physicians, and staff.

KEY RESPONSIBILITIES

• 1. Obtains and/or verifies patient demographic & insurance information, and updates appointment status in NextGen per NextGen standards.
• 2. Schedule patient referrals internally and externally.
• 3. Verifies information on referral is accurate and complete.
• 4. Obtain precertification through private insurance if applicable.
• 5. Notifies patients if a copayment is required for outside services.
• 6. Verifies enrollment of patients to Cooper Green.
• 7. Verifies insurance benefits.
• 8. Answers phone & take complete, accurate messages. Makes sure messages are routed to appropriate person in a timely manner.
• 9. Accurately schedules patient appointment with appropriate information and accuracy.
• 10. Assist with reporting as needed.
• 11. Obtain appointment date/time for patients referred outside of CGMHSA.
• 12. Ensure that information entered into EMR is complete and accurate.
• 13. Other duties as assigned.

Qualifications

MINIMUM QUALIFICATIONS

Position requires a high school diploma or equivalent. College degree or relevant coursework may substitute for part of experience requirement. Professional telephone courtesy is a must. Candidates must have at least one year working in a medical practice setting. This position is responsible for ensuring that referrals are handled effectively and in a timely manner.

Must: (1) Attend all required course work assigned by management; (2) possess basic knowledge of medical terminology and advanced knowledge of PC applications, software, and database management; (3) possess exceptionaltelephone & customer service skills; and (4) be knowledgeable of English grammar & punctuation.

Preferred:

• CHAA Certification from National Association of Healthcare Access.
• Familiarity with medical terminology

WORK ENVIRONMENT

This role may require lifting up to 50 lbs.

The work location for this role is onsite.

PAY RANGE

$15.00-$22.75 hourly

Job Category

Clerical & Administrative

Organization

ACC-ACC-RFRL Patient Access Referral Svcs S