Authorization Specialist Jobs

Job Details:

The Authorization Specialist is responsible for performing complex clerical procedures related to verifying insurance information and obtaining authorization for inpatient admissions and specialized clinical procedures and treatments in accordance with established rules procedures, specified time frames, and regulatory requirements. The Specialist processes clinical information in a timely manner to prevent treatment delays and to avoid denials from third party payers and maintains confidentiality of patient information.

RESPONSIBILITIES:

• Reviews daily discharge statistics in ConnectCare software.
• Verifies insurance eligibility with third party payers using internet websites and RTE.
• Responds to customer inquiries and provides information.
• Advises patients and clinical staff of problems with insurance authorizations and re-submits requests with additional or revised information.
• Communicates with case managers, hospital personnel, and external agencies to provide information or resolve discrepancies.
• Contacts insurance providers to confirm level of benefits for inpatient admissions.
• Follows up with patients, physicians, clinical and ancillary departments to ensure optimum delivery of services.
• Collects demographic and insurance data and enters accurately in to specialized automated systems.
• Serves as liaison between the physician’s offices, patients, case management department and Patient Registration.
• Makes contacts to obtain missing information for incomplete forms.
• Enters and retrieves information from various automated systems and prepares specialized reports.
• Prepares, reviews for completion, and maintains required documents in accordance with established procedures, time frames and regulatory requirements.

QUALIFICATIONS/REQUIREMENTS:

Two to three years of clerical experience in health care field or related area required; experience in an outpatient setting preferred.

EDUCATION:

A high school diploma or equivalency required.

OTHER:

If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

About Us:

Bon Secours Community Hospital

For nearly a century, Bon Secours Community Hospital in Port Jervis, NY, has served the residents of western Orange County, NY, Pike County, PA, and northern Sussex County, NJ, as the area’s premier healthcare provider. The hospital serves its community with 122 beds for acute care and medical-surgical services, a 24-hour emergency department, long-term care and rehabilitation, a dedicated bariatric surgery unit, behavioral health, and outpatient services.