Medical Authorization Specialist

Medical Authorization Specialist Non-Exempt Staring at $21.00 & Up Based on Experience Summary As the Medical Authorization Specialist at Metro Vein Centers, you will play a key role in ensuring accuracy and efficiency in the authorization process. You will be responsible for managing and optimizing the cases assigned to you. Essential functions Verify information about patient insurance coverage, and eligibility. Review documentation for medical necessity against the paser-specific policy to reduce denials Request and obtain prior authorizations for patient treatment plans for all required insurances Coordinate and follow up on denials including scheduling peer to peers and submitting appeals Assists as needed with collection activities on accounts involving prior authorization activity. Including accepting phone calls related to prior authorization questions from patients & staff Maintains the strictest confidentiality in accordance with HIPAA regulations and clinic requirements. Perform other responsibilities as needed or required. Competencies Requires attention to detail Skilled in the use of computers. Including; the ability to utilize spreadsheets, the ability to navigate the internet and websites and basic use of a calculator. Must have strong interpersonal skills to establish and utilize working relationships internally and externally within the health insurance community and company. Ability to work effectively on your own and in a team environment. Strong written and verbal communication skills. Required education and experience Requires a high school diploma or GED. 2 years experience with CPT and ICD-10 coding practices and procedures. 2 years experience with health insurance carrier operations, including but not limited to; third-party administrators, fee schedules, and spectrum of health insurance products, including Medicare, Medicaid, commercial and HMO plans. Work environment Office/Hybrid Physical demands sitting standing for long periods of time lift up to 15 lbs. Travel required None Additional eligibility requirements Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.