Healthcare Authorization Specialist - Fast-Paced Claims

CHA Hollywood Presbyterian Medical Center; Los Angeles (CA); On-site; USD 42,000 - 62,000; Full time

Job summary

CHA Hollywood Presbyterian Medical Center seeks an Authorization Support professional to perform telephone and online authorizations for routine services, contacting care providers and monitoring continues stay authorizations.

The role works with case managers, billers and the care team to gather information, obtain approvals from payors, and resolve pended claims while ensuring patient data confidentiality.

Qualifications

• 2 years of billing experience for a healthcare facility.
• Ability to communicate effectively verbally and in writing.
• Must be able to work in a union environment.

Responsibilities

• Assists in gathering information needed to determine continued clinical authorization. Provides data entry, as appropriate.
• Contacts case managers/ providers with authorization, denial and appeal process information. Assists in educating and acts as a resource to primary care and specialty providers.
• Works closely with case managers, billers and support team to accomplish authorization/ verification.
• Obtains authorization from health plan, IPA, medical group's case managers.
• Works and resolve pended claims received without prior authorization.
• Serve as subject matter expert for assigned payor(s) as directed by patient access leadership while demonstrating broad knowledge of all payors in the hospital portfolio.
• Performs telephone and/ or on-line authorization for routine services, contacting care providers, monitoring concurrent and discharged authorization.
• Performs online data entry and scanning of routine authorizations, continued stay authorization and denial

Skills

Effective communication

Confidentiality

Team collaboration

Education

High School diploma or GED

Job description

CHA Hollywood Presbyterian Medical Center seeks an Authorization Support professional to perform telephone and online authorizations for routine services, contacting care providers and monitoring continues stay authorizations.

The role works with case managers, billers and the care team to gather information, obtain approvals from payors, and resolve pended claims while ensuring patient data confidentiality.