Medical Authorization Specialist
il y a 3 semaines
The Opportunity
We are seeking a highly skilled and experienced Authorization and Billing Specialist to join our team at Rooted Life. As a key member of our financial operations team, you will play a critical role in ensuring the smooth and efficient processing of medical authorizations and billing.
The Job
As an Authorization and Billing Specialist, you will be responsible for managing the entire authorization and billing process, from initial insurance verification to final payment. You will work closely with our clinical teams to ensure that all necessary documentation is collected and submitted in a timely manner. Your expertise in claims processing software, such as Availity and Office Ally, will be essential in streamlining our billing processes and maximizing reimbursement.
Responsibilities
- Collect and review patient demographic and insurance data to ensure accurate authorization and billing
- Manage and submit all necessary documentation and diagnoses for authorizations
- Provide daily updates on the status of authorization requests to ensure optimum service delivery
- Focus on ensuring maximum reimbursement through meticulous billing and coding for all services rendered
- Manage the full claims process in our EHR, from creation to follow-up, handling insurance inquiries with expertise
- Uphold the strictest confidentiality and adhere to all HIPAA regulations
- Confirm and document the patient's health insurance details, including effective dates, network status, and coverage requirements
- Utilize problem-solving skills to address any issues arising from insurance coverage or prior authorizations
- Keep updated with contract limitations and details for each Managed Care Plan (MCP) and stay informed about the services and programs offered by Rooted Life
The Ideal Candidate
- Has at least 5 years of experience in an Authorization and/or Medical Billing role within the Healthcare industry
- Has working knowledge of Medical Billing, Revenue Cycle Management (RCM), and Insurance Authorizations, with a proven track record of developing efficient processes in one or all of these areas
- Possesses strong analytical skills and is comfortable dealing with numerical data
- Is highly goal-driven and works well in fast-paced environments
- Pays strong attention to detail and delivers work of a high standard
- Has knowledge of insurance verification, prior-authorization, and office coordination
About Rooted Life
Rooted Life is a compassionate and innovative organization operating in California, dedicated to aiding those experiencing homelessness, recovering from hospital stays, or facing housing challenges. Our mission is to guide individuals through the journey of finding and securing safe, stable homes. We provide essential services, including financial assistance for initial housing costs and ongoing support to maintain stable living situations.
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