Authorization and Appeals Specialist

Job Description

Job Description

osition Summary

The Authorization / Appeal Specialist is responsible for filing appeals for all authorization denials on the Case Processing team and training and back up all the Authorization Coordinators on the Case Processing team.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following :

• File appeals on all authorization that have been denied
• Start and follow up on the insurance authorization process
• Train and support Authorization Coordinators
• Create medical documents
• Update patient files with relevant information
• Communicate with insurance companies by fax, email and telephone
• Effective communication with patients, sales team and corporate staff regarding the status of the patient’s authorization
• Willing to support all members of the team
• Comply with all HIPAA and privacy regulations
• Adhere to laws and best practices in regards to dealing with patients and patient data
• Perform other job-related duties as assigned

Minimum Qualifications (Knowledge, Skills, and Abilities)

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

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