Authorization Specialist at Crystal Clinic Orthopaedic Center, LLC in Akron, Ohio

Job Description:

Position Summary

The Authorization Specialist obtains authorization and precertification from insurance companies for tests and surgeries. Performs insurance billing clerical work including review and verification of insurance accounts against program provisions for billing in a clinic/physician office setting.

Essential Job Functions/Accountabilities

Obtains and compiles documentation to submit to insurance companies, initiating the authorization process. Utilizes phone or website to initiate and obtain authorization for procedure(s) or surgeries.

Maintains appropriate logs or reports. Monitors and tracks the authorizations, notifies the physicians secretary of any issues, approvals, and/or denials.

Coordinates with patients, clinic staff, and insurance companies to obtain authorization. Prioritizes authorization requests according to urgency.

Coordinates and/or communicates the need for appeals based on denied authorizations.

Provides adequate documentation in patients charts of authorization, approval, and/or denial, including, but not limited to, authorization numbers, insurance representatives name, and dates of approval.

All other duties not specifically assigned.

Positions Requirements

Education: High school diploma or GED required.

Experience: Three (3) to Five (5) years of demonstrated experience in field or profession preferred. Medical office experience preferred.

Technical Skills: Excellent customer service and organizational skills. Professionalism. Attention to detail. Excellent computer skills including Excel, Word, Internet use, and ability to work within multiple EMRs.

Certifications/Licenses/Registrations: N/A