Authorization Specialist

Job Summary

A company is looking for an Authorization Specialist.

Key Responsibilities

• Obtain benefits and authorizations for surgical procedures, diagnostic testing, medications, and referrals
• Collaborate with physicians and staff to ensure proper authorization based on medical necessity
• Communicate with insurance companies for verification and precertification of benefits

Required Qualifications

• High School Diploma/GED with specialized training in insurance, coding, or billing
• 1 year of experience in a healthcare setting with insurance verification/authorizations
• Familiarity with billing procedures and payer reimbursement
• Knowledge of patient rights and relevant laws, including HIPAA
• Proficient in utilization management processes and standard medical practices