Authorization Specialist Job – West Columbia, SC

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Why You’ll Love This Job

Palmetto Retina Center, a busy 10 MD ophthalmology practice specializing in retina diseases is currently seeking an experienced authorization specialist. The authorization specialist receives authorization from the insurance carrier prior to providing medically necessary treatment to patients. They verify patient insurance and benefits, patient referrals, insurance authorizations, workers’ compensation cases, patient financial counseling, and medical billing functions. As well as conveys necessary information accurately, listens effectively, and asks questions when clarification is needed.

Job Duties and Responsibilities

  • Ensures complete and accurate patient or client setup, performs full benefits verification on clients, including contacting payers to investigate and verify the terms and benefits of clients’ insurance policies as well as cost.
  • Facilitates process for requesting Medical Authorizations, and Prior Authorizations for medical claims.
  • Works closely with Clinical Administration and Billing Departments to assist patients with insurance approvals.
  • Provides guidance to healthcare providers and patients in connection with documentation required for payer coverage.
  • Provides feedback to management and the rest of the billing team to ensure claims are billed out correctly.
  • Identifies account issues and trends and works with management for resolution
  • Updates providers regarding changes related to regulations.
  • Plans and organizes work effectively, meets all productivity requirements, and ensures its completion.

Qualifications

Minimum Background Requirements:
•Two years of billing in a healthcare environment is a requirement.
•One year of experience collecting on medical accounts.
•One year experience conducting authorizations in a healthcare environment.
•Word processing and computer experience is required.

Minimum Education Requirements:
•High School diploma or the equivalent is required.
•An Associate’s degree in medical office technology, or a related area, or an equivalent combination of education and experience, from which comparable knowledge, skills, and abilities can be acquired, is required.

Minimum Demonstrated Skills/Qualifications:
•Position requires accuracy, thoroughness, and an understanding of insurance, referral procedures, and authorizations.
•Work is fast-paced and multi-tasked.
•Requires ability to work as a team member.
•Skill in operating computers, word processing software, fax machines, and copier machines.
•Creative idea-generating individual with excellent follow-through abilities

Physical Demands:
•Requires sitting for long periods with occasional bending required.
•Must be able to view and enter data into the computer for extended periods.
•Must be able to communicate via the telephone.

EEO Statement:
Palmetto Retina Center, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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Type: Full Time (Hourly)
Job ID: 139545