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Insurance Authorization Specialist

Insurance Authorization Specialist

CompanyNorthwell Health
LocationPort Jefferson, NY, USA
Salary$Not Provided – $Not Provided
TypeContract
Degrees
Experience LevelJunior, 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.