Alliance Health System
Authorization Specialist
Authorization Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers.
RESPONSIBILITIES
Review chart documentation to ensure patient meets medical policy guidelines
Prioritize incoming authorization requests according to urgency
Obtain authorization via payer website, fax or by phone and follow up regularly on pending submission
Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
Initiate appeals for denied or modified authorizations
Respond to clinic questions regarding payer medical policy guidelines
Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
Knowledge of treatment authorization and its direct impact on the practice's revenue cycle
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
Proficient use of CPT and ICD-10 codes
Excellent computer skills including Adobe, Excel and Internet use
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Excellent customer service skills; communicates clearly and effectively
Ability to efficiently manage and prioritize time-sensitive tasks that arise
EDUCATION/EXPERIENCE REQUIRED
High School Diploma or GED
2 years medical prior authorization experience preferred
2 years experience with MD providers - Orthopedics & Pain preferred.
Job Type:
Full-time
Monday to Friday
Work Remotely:
Hybrid Remote
Benefits:
401(k) matching
Health insurance
Paid time off
Paid Holidays
Authorization Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers.
RESPONSIBILITIES
Review chart documentation to ensure patient meets medical policy guidelines
Prioritize incoming authorization requests according to urgency
Obtain authorization via payer website, fax or by phone and follow up regularly on pending submission
Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
Initiate appeals for denied or modified authorizations
Respond to clinic questions regarding payer medical policy guidelines
Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
Knowledge of treatment authorization and its direct impact on the practice's revenue cycle
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
Proficient use of CPT and ICD-10 codes
Excellent computer skills including Adobe, Excel and Internet use
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Excellent customer service skills; communicates clearly and effectively
Ability to efficiently manage and prioritize time-sensitive tasks that arise
EDUCATION/EXPERIENCE REQUIRED
High School Diploma or GED
2 years medical prior authorization experience preferred
2 years experience with MD providers - Orthopedics & Pain preferred.
Job Type:
Full-time
Monday to Friday
Work Remotely:
Hybrid Remote
Benefits:
401(k) matching
Health insurance
Paid time off
Paid Holidays