Insurance Authorization Specialist II

Remotemid

Other

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Quick Summary

Key Responsibilities

As an advocate for WVUH/UHA employees, company and departmental goals and initiatives and HR Compliance,

Requirements Summary

EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school graduate or equivalent with 2 y

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About the Role

~1 min read

This position is responsible for obtaining authorizations for elective procedures, services, and tests to financially clear patients prior to services are rendered. Payor resources and any other applicable reference material such as payor and medical policies should be utilized to verify accurate prior authorization requirements. Cases are to be coded, and clinical documentation reviewed to ensure the documentation is complete. Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program. This role is key to securing reimbursement and minimizing organizational write offs, while supporting the goals of keeping surgery room and schedules at optimal levels.

Requirements

~1 min read

1. High school graduate or equivalent with 2 years working experience in a medical environment, (such as a hospital, doctor’s office, or ambulatory clinic.)

2. Associate’s degree and 1 year of experience in a medical environment required.

1. 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.

2. Understanding of authorization processes, insurance guidelines, and third-party payors
3. Proficiency in Microsoft Office applications.

4. Excellent communication and interpersonal skills.

5. Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.

6. Basic computer skills.