Authorization Specialist

 

Essential Responsibilities: 

• This description of job responsibilities is intended to reflect the major responsibilities and duties of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time.
• Completes authorizations and medical necessity verifications for scheduled and unscheduled services.
• Conducts a daily reconciliation comparison of authorized procedures versus charges and requests additional authorizations if necessary. 
• Contact referring physicians for additional information as needed.
• Communicate with patient or representative about authorization status, covered benefits, and financial liability as needed.
• Proactively monitor appointment lists and work queues to ensure that patients receive timely services and that those services are approved.
• Maintain thorough and accurate records within the electronic health record. 
• Assist with investigating and discovering additional coverage or benefits for uninsured and underinsured. 
• Assist with other clerical tasks as needed.
• Register and Schedule patients as needed.