Prelude Fertility
Authorization Specialist
Prelude Fertility, Houston, Texas, United States, 77246
The Authorization Specialist is responsible for providing a great patient experience by checking patient eligibility and initiating prior authorizations. Includes utilizing online resources, reviewing medical records, calling insurance companies, and completing authorization forms in our Electronic Medical Record system.
ESSENTIAL RESPONSIBILITIES:
Check patient eligibility and insurance plan benefits via online payer portals and confirming with insurance companiesScan complete authorization form in EMR systemReview medical recordsInitiate authorizations using online resources, insurance specific forms, and making outgoing calls to insurance companiesFollow department procedures to ensure timely completion of benefit investigationsCommunicate with internal patient financial services department, clinical staff and external practice managers when inaccurate demographic information is suppliedReview and update authorization information in the EMR systemSupport and actively participate in initiatives designed to improve individual and organizational performance.Coordinate with clinical staff to set up peer to peer meetings for physicians and insurance medical directors.Assist patients with insurance denials and appealsPerforms other duties/special projects and tasks as assignedKNOWLEDGE AND SKILLS:
Able to read, interpret, and implement specified records.Knowlege of Medical and Diagnosis codes (CPT/DX)Demonstrated knowledge of medical terminology and office procedures.Demonstrated knowledge of third-party and insurance company operating procedures, regulations and billing requirements.Experience with Microsoft Office suite and Electronic Medical Record (EMR) system.Ability to effectively establish and maintain cooperative and effective working relationshipsEffectively prioritize competing responsibilities, with a sensitivity toward matters which are time sensitive.Exercise a high level of discretion and sensitivity to patient privacy.Ability to recognize, evaluate, solve problems and correct errors.Ability to use telephone, keyboard, computer, office equipment and software programs.EDUCATION AND/OR EXPERIENCE:
High School diploma or equivalent required1-3 years' work experience in a healthcare environment requiredInception offers fantastic benefits to our team (Family members):
FREE employee only coverage option for the medical, dental and vision plans plus FREE basic life insurance, EAP and long-term disability insurance!Adoption assistance and fertility benefitsMaternity and paternity/partner paid leave401k with generous match11 Company-paid holidaysPTO starting at 18 days/yearFamily member recognition programContinuing education/professional development reimbursement and time offFamily member referral program
ESSENTIAL RESPONSIBILITIES:
Check patient eligibility and insurance plan benefits via online payer portals and confirming with insurance companiesScan complete authorization form in EMR systemReview medical recordsInitiate authorizations using online resources, insurance specific forms, and making outgoing calls to insurance companiesFollow department procedures to ensure timely completion of benefit investigationsCommunicate with internal patient financial services department, clinical staff and external practice managers when inaccurate demographic information is suppliedReview and update authorization information in the EMR systemSupport and actively participate in initiatives designed to improve individual and organizational performance.Coordinate with clinical staff to set up peer to peer meetings for physicians and insurance medical directors.Assist patients with insurance denials and appealsPerforms other duties/special projects and tasks as assignedKNOWLEDGE AND SKILLS:
Able to read, interpret, and implement specified records.Knowlege of Medical and Diagnosis codes (CPT/DX)Demonstrated knowledge of medical terminology and office procedures.Demonstrated knowledge of third-party and insurance company operating procedures, regulations and billing requirements.Experience with Microsoft Office suite and Electronic Medical Record (EMR) system.Ability to effectively establish and maintain cooperative and effective working relationshipsEffectively prioritize competing responsibilities, with a sensitivity toward matters which are time sensitive.Exercise a high level of discretion and sensitivity to patient privacy.Ability to recognize, evaluate, solve problems and correct errors.Ability to use telephone, keyboard, computer, office equipment and software programs.EDUCATION AND/OR EXPERIENCE:
High School diploma or equivalent required1-3 years' work experience in a healthcare environment requiredInception offers fantastic benefits to our team (Family members):
FREE employee only coverage option for the medical, dental and vision plans plus FREE basic life insurance, EAP and long-term disability insurance!Adoption assistance and fertility benefitsMaternity and paternity/partner paid leave401k with generous match11 Company-paid holidaysPTO starting at 18 days/yearFamily member recognition programContinuing education/professional development reimbursement and time offFamily member referral program