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Authorization Specialist

Conway Medical Center

Conway, SC

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JOB DETAILS
SKILLS
Communication Skills, Computer Skills, Customer Support/Service, Documentation, Health Insurance, Health Maintenance Organization (HMO), Healthcare Common Procedure Coding System (HCPCS), ICD-10, Insurance, Leadership, Medicaid, Medical Billing, Medical Record System, Medical Records, Medical Terminology, Medicare, Patient Assessment, Patient Education, Preferred Provider Organization (PPO), Presentation/Verbal Skills, Reimbursement, Testing, Writing Skills
LOCATION
Conway, SC
POSTED
2 days ago
Position Summary:
The Authorization Specialist (AS) is assigned patients to obtain insurance to determine if an authorization is required for the testing/procedure being ordered by the requesting physician/practitioner. The Authorization Specialist AS will check patient demographics and more importantly insurance information to ensure Conway Medical Center has the most up-to-date information for accurate reimbursement submission.

Qualifications

Education:

  • High School Diploma required.

Experience:

  • Two (2) years’ experience in hospital and/or physician billing/pre-authorization or insurance verification.
  • Demonstrated knowledge of health insurance plans including: Medicare; Medicaid, HMO’s; and PPO’s required.
  • Familiarity with electronic health records (E.H.R.) and documentation requirements and accessibility.
  • Knowledge of online insurance eligibility and insurance verification systems.

Licensure/Certification/Registration:

  • Medical Terminology certification preferred.
  • Certification or Associate degree in ICD-10-CM/ICD-10-PCS; CPT, HCPCS preferred
  • Certified Health Access Associate credential preferred

Duties & Responsibilities:

  • Collaborates with designated clinical contacts that require escalation to peer-to-peer review.
  • Facilitates submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policies and procedures and maintaining departmental productivity and quality goals.
  • Educate and counsel patients on their insurance coverage and explain payment options that are available to them.
  • Work with front line staff to ensure collections are secured at time of presentation.
  • Always displays exemplary core customer service skills.
  • Consistently display effective verbal and written communication skills.
  • Proficient understanding and use of technology/PC skills required.
  • Work well in a fast-paced environment; efficiently organize work and maintain a high level of accuracy and productivity.
  • Completeother duties as assigned by department leadership.

About the Company

C

Conway Medical Center

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