Insurance Authorization Specialist
| Company | Northwell Health |
|---|---|
| Location | Port Jefferson, NY, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Contract |
| Degrees | |
| Experience Level | Junior, Mid Level |
Requirements
- Knowledge of CPT and ICD-10 coding; familiarity with ICD-9 is a plus.
- Minimum of 2 years of experience
- Strong understanding of medical terminology.
- Excellent communication skills, both written and verbal
- Proficiency in electronic medical record (EMR) systems and basic computer skills.
- Familiarity with insurance policies, guidelines, and pre-authorization requirements.
- Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
- Strong attention to detail and organizational skills.
Responsibilities
- Review and obtain insurance authorizations
- Verify patient eligibility and coverage details with insurance providers
- Communicate effectively with insurance companies to resolve any authorization issues or discrepancies that arise.
- Regularly update clinical staff on the status of pre-authorizations and document approvals or denials in the EMR system.
- Maintain accurate records
- Stay informed of current insurance policies and guidelines to ensure compliance
- Schedule peer-to-peer (P2P) reviews with providers to obtain necessary approvals.
- Coordinate the submission of appeals for denied authorizations and provide necessary documentation as required.
- Update the team on new clinical guidelines and changes to authorization processes.
- Train new team members on authorization processes and procedures.
- Assist with front desk duties and patient intake as needed.
- Perform other duties as assigned
Preferred Qualifications
-
No preferred qualifications provided.