Authorization Specialist
West Allis, WI West Allis, WI Contract Contract $27 - $31 an hour $27 - $31 an hour 21 hours ago 21 hours ago 21 hours ago Duration:
03 months contract with strong possibility of extension.
Job Description :
Maintains, confirms and secures referrals, authorization, or pre-certifications required for patients to receive physician or medical services.
Verifies the accuracy and completeness of patient account information.
Maintains database of payer authorization requirements Major
Responsibilities:
Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems.
Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients.
Follows up with physician offices, financial counselors, patients and third-party payers to complete the pre-certification process.
Collaborates with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations.
Educates patients, staff and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends.
Ensures all services have prior authorizations and updates patients on their preauthorization status.
Coordinates peer to peer review if required by insurance.
Notifies patient accounts staff/patients of insurance coverage lapses, and self-pay patient status.
May notify ordering providers if authorization/certification is denied.
May coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures.
Maintains files for referral and insurance information, and enters referrals into the system.
Maintains knowledge of and reference materials of the following:
Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre- authorization and a list of current accepted insurance plans.
Required Skills:
Must have 1 year of experience in providing customer service that includes experiences in patient accounts, third-party payer plans, accounts receivable/collection processes, and medical clinic processes and workflow Must have understanding of basic human anatomy, medical terminology and procedures for application in the patient referral/ precertification/ authorization processes.
Knowledge of third-party payers and pre-authorization requirements.
Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral / precertification / authorization processes.
Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, physician practice management, and electronic medical records systems.
Education Required:
High School Diploma (Required) Job Type:
Contract Salary:
$27.
00 - $31.
00 per hour Weekly day range:
Monday to Friday Ability to commute/relocate:
West Allis, WI 53227:
Reliably commute or planning to relocate before starting work (Required) Application Question(s):
Are you comfortable to work on 3 Months contract with possible extension?
Experience:
Insurance verification:
1 year (Required) Work Location:
In person Maintains, confirms and secures referrals, authorization, or pre-certifications required for patients to receive physician or medical services.
Verifies the accuracy and completeness of patient account information.
Maintains database of payer authorization requirements.
Estimated Salary: $20 to $28 per hour based on qualifications.
03 months contract with strong possibility of extension.
Job Description :
Maintains, confirms and secures referrals, authorization, or pre-certifications required for patients to receive physician or medical services.
Verifies the accuracy and completeness of patient account information.
Maintains database of payer authorization requirements Major
Responsibilities:
Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems.
Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients.
Follows up with physician offices, financial counselors, patients and third-party payers to complete the pre-certification process.
Collaborates with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations.
Educates patients, staff and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends.
Ensures all services have prior authorizations and updates patients on their preauthorization status.
Coordinates peer to peer review if required by insurance.
Notifies patient accounts staff/patients of insurance coverage lapses, and self-pay patient status.
May notify ordering providers if authorization/certification is denied.
May coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures.
Maintains files for referral and insurance information, and enters referrals into the system.
Maintains knowledge of and reference materials of the following:
Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre- authorization and a list of current accepted insurance plans.
Required Skills:
Must have 1 year of experience in providing customer service that includes experiences in patient accounts, third-party payer plans, accounts receivable/collection processes, and medical clinic processes and workflow Must have understanding of basic human anatomy, medical terminology and procedures for application in the patient referral/ precertification/ authorization processes.
Knowledge of third-party payers and pre-authorization requirements.
Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral / precertification / authorization processes.
Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, physician practice management, and electronic medical records systems.
Education Required:
High School Diploma (Required) Job Type:
Contract Salary:
$27.
00 - $31.
00 per hour Weekly day range:
Monday to Friday Ability to commute/relocate:
West Allis, WI 53227:
Reliably commute or planning to relocate before starting work (Required) Application Question(s):
Are you comfortable to work on 3 Months contract with possible extension?
Experience:
Insurance verification:
1 year (Required) Work Location:
In person Maintains, confirms and secures referrals, authorization, or pre-certifications required for patients to receive physician or medical services.
Verifies the accuracy and completeness of patient account information.
Maintains database of payer authorization requirements.
Estimated Salary: $20 to $28 per hour based on qualifications.
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