- 2+ years of recent prior authorizations experience required
- Orthopedics experience preferred
- High school diploma or GED required
- Must successfully pass a criminal background check and drug screen
- Monitor the authorizations of upcoming surgical cases on the physician's calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner
- Verify patient demographic information and insurance eligibility including coordination of benefits
- Update and confirm necessary information to allow processing of claims to insurance plans
- Accurately complete surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services
- Verify benefits on all surgical procedures
- Document authorizations and progress of authorizations in the patient's chart
- Enter the authorization information within case management
- Communicate effectively with physicians, patients, and coworkers and establish good working relationships with both internal and external customers
- Provide ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases
- Work with department manager to respond to and reduce complaints timely and professionally
- Assist surgery schedulers with STAT authorizations
- Ensure strict confidentiality of all health records and member information and meet HIPAA guidelines
- Assist in identifying opportunities for improvement within the daily workflow process
- Attend department meetings as required
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Authorization Representative - Phoenix, United States - Health Advocates Network
Description
Contract to HireJob # 24148 Authorization Representative
Acclivity Healthcare - Your personable, proven partner
Since 1999, Acclivity Healthcare has served the specialized recruiting and staffing needs of leading healthcare employers nationwide. Our clients range from independent physician practices to national healthcare systems and insurance providers. We are proud of our 18,000+ successful placements with quality-oriented organizations that recognize the value of better talent.
Compensation and Schedule for the Authorization Representative
Authorization Representative –?Full-time, onsite, $19-$20?per hour, Monday – Friday, 8:00am to 5:00pm. Join a family environment with huge growth potential
Required Qualifications of the Authorization Representative
Responsibilities of the Authorization Representative
About the Company
This well-known and successful healthcare system has remained a symbol of quality in Arizona for the past decade.
They are one of the fastest growing medical management companies, and they have won numerous awards as a top healthcare employer because of the great work environment and commitment to the development of their employees.
This fast-paced organization has an immediate need for several organized and friendly Authorization Representatives to join their teamHealth Advocates Network, Inc. is an equal opportunity employer.
All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies.
EOE including Veterans/Disability
