Overview
As an Authorization Specialist, you'll verify insurance coverage, benefits, and obtain prior authorization for services.
Responsibilities
- Contacts insurance plans to determine eligibility, obtains coverage, benefit information, and prior authorization for services
- Processes requests for prior authorization from clinics and Patient Care Coordinators
- Documents findings thoroughly and accurately
- Makes changes to demographic information as necessary in order to produce a clean patient statement
- Meets or exceeds productivity standards in the completion of daily assignments and accurate production
- Maintains an error rate in accordance with departmental policy
- Performs training with organizational staff on procedures for requesting, documenting and processing prior authorizations
- Performs additional duties as assigned
Qualifications
- High School Diploma or GED
- 2+ years of experience in medical billing environment or insurance verification is a plus
- Ophthalmology background is a plus
- Active knowledge of CMS guidelines contracted insurance guidelines and coding policies
- Demonstrated computer and math skills
- Detail oriented, reliable and able to multi-task in a fast-paced, high-volume work environment
- Excellent verbal and written communication skills
- Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism
Benefits & Perks
Your health, happiness and your future matters! At AVP, we offer everything medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
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