Authorization Specialist

Job Summary

A company is looking for an Authorization Specialist.

Key Responsibilities

• Obtains benefits and authorizations for various medical services, ensuring compliance with network policies
• Collaborates with healthcare providers to verify medical necessity and communicates with insurance companies for authorization
• Monitors and reviews schedules to ensure accurate authorizations are received prior to patient visits

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 involving insurance verification and authorizations
• Familiarity with billing procedures and payer reimbursement
• Knowledge of patient rights and relevant laws, including HIPAA
• Proficient in utilization management processes and insurance benefit structures