Swift Care Authorization Specialist

Talentify; Santa Ana (CA); On-site; USD 45,000 - 65,000; Full time

Job summary

Talentify in California is seeking an Authorization Specialist to ensure timely verification and validation of authorizations for Commercial and Managed care inpatients and other services.

You will contact insurance companies by phone or web, review discharged patients for authorization entries, and obtain missing authorizations within 3–7 days while maintaining clear documentation and collaboration with Case Management.

Qualifications

• High school diploma or equivalent or relevant combination of experience and education.
• Minimum of two years of experience in scheduling, authorization and referrals in a health care setting.

Responsibilities

• Verify and validate authorizations for Commercial and Managed care inpatients and other services.
• Contact insurance companies to secure authorization via phone or website.
• Review discharged managed care patients for authorization entry in the system.
• Obtain missing authorizations within 3–7 days of discharge or within 7 days of admission as applicable.
• Check bill hold weekly for pending authorizations.
• Assist with sending delinquent reviews and resending reviews not received by payors.
• Communicate with Case Management and other departments to obtain authorizations.
• Maintain analysis of authorization issues by payer and document all contacts.
• Report monthly summary of authorization issues to senior leadership.
• Follow hospital policies and documentation requirements for authorizations.

Skills

Attention to detail

Communication skills

Follow-up skills

Education

High school diploma or equivalent

Job description

Talentify in California is seeking an Authorization Specialist to ensure timely verification and validation of authorizations for Commercial and Managed care inpatients and other services.

You will contact insurance companies by phone or web, review discharged patients for authorization entries, and obtain missing authorizations within 3–7 days while maintaining clear documentation and collaboration with Case Management.