Job Description
Job Description
Here's a professional Authorization Specialist job description that includes experience with eClinicalWorks (eCW) :
Job Title : Authorization Specialist
Location : Drg pain and Orthopedics
Department : Revenue Cycle / Front Office / Medical Billing
Reports To : Billing Supervisor / Practice Manager
Job Summary :
We are seeking a detail-oriented and efficient Authorization Specialist with hands-on experience in eClinicalWorks (eCW) . The Authorization Specialist is responsible for verifying insurance coverage, obtaining prior authorizations for procedures, imaging, referrals, and medications, and ensuring all required documentation is accurately entered into the eCW system. This role plays a vital part in optimizing patient access to care while ensuring compliance with payer guidelines.
Key Responsibilities :
- Request and obtain prior authorizations for procedures, diagnostic tests, specialist referrals, and medications using payer portals and telephone communication
- Utilize eClinicalWorks (eCW) to input, track, and monitor all authorization-related activities and documentation
- Review patient charts and physician orders to gather required information for authorization requests
- Communicate with insurance companies to follow up on pending authorizations and resolve any issues or denials
- Notify clinical staff and patients of authorization approvals, denials, or additional information needed
- Ensure timely submission of all authorization requests to avoid appointment delays or claim denials
- Maintain up-to-date knowledge of insurance guidelines, payer policies, and authorization requirements
- Collaborate with scheduling, billing, and clinical teams to ensure a smooth patient experience
- Accurately document all communication and status updates in eCW and maintain detailed authorization logs
- Respond to inquiries from patients or staff regarding insurance coverage and authorization status
- Perform insurance eligibility checks and benefit verifications when needed
Qualifications :
High School Diploma or equivalent required; Associates degree preferredMinimum 2 years of experience in medical authorization or insurance verificationProficient in eClinicalWorks (eCW) or similar EHR systemsStrong understanding of medical terminology, CPT / ICD-10 codes, and insurance processesKnowledge of commercial insurance, Medicare, Medicaid, and managed care plansExceptional attention to detail and organizational skillsAbility to handle confidential information in accordance with HIPAA guidelinesStrong communication skills (both verbal and written)Bilingual (English / Spanish) is a plusWork Schedule :
Full-time, Monday Friday, 8-4
Compensation :
[Include salary range or indicate commensurate with experience and mention any benefits like PTO, health insurance, etc.]
Let me know if you'd like this tailored to a specific medical specialty (e.g., cardiology, orthopedics, imaging center), or rewritten in resume or job ad format.