Authorization Specialist

Job Description

Job Description

About the Role :

The Authorization Specialist at Wagoner Community Hospital (WCH) plays a critical role in ensuring that patients receive timely and appropriate healthcare services by managing the pre-authorization process with insurance providers. This position is responsible for verifying patient insurance coverage, obtaining necessary approvals for medical procedures, and coordinating with healthcare providers to facilitate seamless patient care. The specialist acts as a liaison between patients, healthcare providers, and insurance companies to resolve any authorization-related issues efficiently. By maintaining accurate records and staying current with insurance policies and regulations, the Authorization Specialist helps minimize delays in treatment and supports the hospital’s operational efficiency. Ultimately, this role contributes to enhancing patient satisfaction and optimizing revenue cycle management within the healthcare setting.

Minimum Qualifications :

• High school diploma or equivalent; Associate’s degree in healthcare administration or related field preferred.
• Minimum of 2 years experience in healthcare authorization, insurance verification, or medical billing.
• Strong knowledge of medical terminology, insurance plans, and healthcare reimbursement processes.
• Proficiency with electronic health records (EHR) systems and authorization management software.
• Excellent communication and organizational skills with attention to detail.

Preferred Qualifications : .

Responsibilities :

Skills :

The Authorization Specialist utilizes strong communication skills daily to interact with insurance companies, healthcare providers, and patients, ensuring clear and effective information exchange. Analytical skills are essential for reviewing insurance policies and patient records to determine coverage and authorization requirements accurately. Organizational skills are applied to manage multiple authorization requests simultaneously while maintaining meticulous documentation and tracking. Proficiency with healthcare software and electronic health records enables efficient processing and updating of authorization statuses. Additionally, problem-solving skills are critical when addressing denials or delays, allowing the specialist to find solutions that facilitate timely patient care and support hospital revenue cycles.