Authorization Specialist Jobs

We’ll ensure the hiring manager prioritizes your interest and schedules an interview quickly.

A streamlined hiring process means offers are often presented within 24-48 hours after an interview with a hiring leader.

Experience The Aya Difference Today

Shift: 5x8-Hour 07:00 - 15:00

A dedicated recruiter who advocates for you every step of the way.

Flexible start dates that work around your availability.

Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements

Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements

Knowledge of current and developing issues and trends in medical coding procedures requirements

Identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval.

Knowledge of appeals concepts and principles

Ability to use independent judgement and to manage and impart confidential information

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

High school diploma or equivalent is required.

Ability to multi-task and support numerous referrals/priorities at one time.

Ability to work in a fast past environment.

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

High school diploma or equivalent is required.

Ability to multi-task and support numerous referrals/priorities at one time.

Ability to work in a fast past environment.

We’ll ensure the hiring manager prioritizes your interest and schedules an interview quickly.

A streamlined hiring process means offers are often presented within 24-48 hours after an interview with a hiring leader.

Experience The Aya Difference Today

Shift: 5x8-Hour 07:00 - 15:00

A dedicated recruiter who advocates for you every step of the way.

Flexible start dates that work around your availability.

Processes benefit verification or authorization for all new and existing patients with speed and accuracy.

Assist AVA Supervisor and Manager to troubleshoot and resolve issues.

Assist AVA Supervisor and Manager with special assignments as needed

Minimum of two years of experience in related experience.

Provides training and mentoring for new hires.

High school diploma or equivalent is required.

Experienced with a knowledge of Availity, MyNexus, Zirmed, Ability, and other common clearinghouses.

Analytical thinkers with strong written and verbal communication skills.

1+ year experience directly completing insurance verifications and requesting authorizations.

Home health/hospice experience is preferred.

Perform routine review of appropriate workflows and redirect workflows as needed.

Demonstrate ability to solve problems independently and at an optimal level.

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

High school diploma or equivalent is required.

Ability to multi-task and support numerous referrals/priorities at one time.

Ability to work in a fast past environment.

Manage referral and authorizations information as assigned

0-2 years of relevant work experience, including healthcare/business administration, health insurance, medical policy/chart review, nursing, and/or other allied health fields

Strong Microsoft Office Suite experience

Experience with Epic is a plus

Perform pre-registration of new patients by making/receiving patient calls collecting and documenting patient demographics, financial, and other relevant personal information

Update changes to patient insurance and/or demographic information as needed

Manage prior authorization process from initial submission to authorization

0-2 years of relevant work experience, including healthcare/business administration, health insurance, medical policy/chart review, nursing, and/or other allied health fields

Strong Microsoft Office suite experience

Review and monitor all radiology authorization imaging exams

Identify all patient access issues creating barriers to prior authorization

Prepare and complete prior authorization request

Case Management, Utilization Review or Prior Authorization experience

Minimum of 2 year of clinical and/or related experience

Shows strong analytical and problem-solving skills.

Superior written and verbal communication skills

Knowledge of third-party payer rules and regulations

High School Diploma or equivalent

2+ years of recent prior authorization experience required

Explain financial policy to patients and discuss financial responsibilities including copays, coinsurances, deductibles and time of service payments

Ensure physician documentation supports payer requirements for authorization processing

Schedule PET and Nuclear appointments after reviewing financial responsibilities with patient

Required Qualifications Of The Authorization Specialist II

Responsibilities Of The Authorization Specialist II

Basic Education And/or Experience Requirements

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

High school diploma or equivalent is required.

Ability to multi-task and support numerous referrals/priorities at one time.

Works with the Order Management team to secure any additional information and medical documentation from the patient and/or prescribing HCP.

Medical terminology and ICD-10 coding: Knowledge of and interpretation skills

One (1) year previous experience of insurance verification or medical authorization experience involving medical record review.

Personal career, skill, and leadership development opportunities

Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.

Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company’s products.

Demonstrates the skills of effective communication decision-making and organization to ensure efficient job performance and job success.

Maintains current working knowledge; adheres to Medical Center and departmental policies and procedures.

In addition to the above job responsibilities, other duties may be assigned.

COVID Vaccination Requirement and Guidelines

Assures all referrals are handled effectively and efficiently.

Analyzes information required to complete pre- authorizations with insurance carriers and service area contacts.

Basic Education and/or Experience Requirements

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

Does this position have supervisory responsibilities? NO

High school diploma or equivalent is required.

Basic Education and/or Experience Requirements

Processes benefit verification or authorization for all new referrals with speed and accuracy.

Assist AVA Supervisor and Manager with special assignments as needed.

Minimum of two years of experience in related experience.

Does this position have supervisory responsibilities? NO

High school diploma or equivalent is required.

Current working knowledge of hospital operations, utilization management, case management, and managed care reimbursement, preferred.

Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.

Strong interpersonal communication and negotiation skills and experience interacting with clinicians and finance personnel.

High School or 3 - 5 years related experience and/or training; or equivalent combination of education and experience, required.

Strong analytical and data management.

Ability to work with all levels of management.

UW Hospital and Clinics benefits

Medical policy review to ensure scheduled procedures will meet medical necessity guidelines set forth by insurance payers.

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Join the #1 hospital in Wisconsin!

Preferred - Graduate of School of Nursing.

Our Commitment to Diversity, Equity, and Inclusion

Education, Certification, Computer and Training Requirements:

Identifies the referral and authorization requirements of the patients’ insurance plans by using various on-line resources according to department workflows

Demonstrates knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization

Verifies insurance eligibility and benefits, and updates the patient’s insurance information as necessary

Provides the supervisor and manager with immediate feedback on issues affecting workflow, reimbursement, and customer service.

Anticipates and performs necessary job duties.