Authorization Specialist

Job Summary

A company is looking for an Authorization Specialist.

Key Responsibilities

• Obtains benefits and authorizations for surgical procedures, diagnostic testing, and other services
• Collaborates with healthcare providers to ensure appropriate authorizations based on medical necessity
• Communicates with insurance companies to verify benefits and obtain necessary precertifications

Required Qualifications

• High School Diploma/GED with specialized training in insurance, coding, billing, or similar healthcare certificate programs
• 1 year of experience in a healthcare setting with insurance verification/authorizations
• Familiarity with billing procedures and payer reimbursement
• Knowledge of patient rights and related laws, including HIPAA
• Proficient in utilization management processes and managed care standards