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Job description
Authorization Specialist II, RCMThe Authorization Specialist II, RCM is a position that performs the authorization requests for all insurances. In this role, you will report to the Authorization Manager, RCM.Duties/Responsibilities:Checking eligibility/benefits on patients as needed: Upon intake if not previously done for all patients, monthly on patients with non-Medicaid insurances, and at the beginning of each month where prior authorization is not requiredAt the beginning of every new year, obtaining details on eligibility, patients deductible and out of pocket costsCommunicating any patients that will have a patient responsibility with the appropriate staff so they can verify the patient will want services and to inform field staff to correctly fill out the consentsTracking and obtaining all authorizations for all locations, along with reauthorization throughout duration of patient careData entering all authorization information into the systemVerifying accuracy in payor setup in EMR for all active policiesMaintain electronic record of all authorizationsRun reports daily, weekly, and monthly for departmentCommunicate with both internal and external customers to ensure authorizations are utilized accuratelyDetermine through eligibility and payer knowledge if the company can service a patientAppeal denials as required by payer, including appeals through the health commission or applicable governing bodyAttend regular meetings with branches as needed to ensure open communicationPerform other duties as assignedRequired Skills/Abilities/Knowledge:Excellent verbal and written communication skills with ability to communicate across all levels of authority within companyExcellent organization, problem solving, and project management skillsAble to independently file appeals with multiple payorsTroubleshoot eligibility issues with internal teams as it relates to insurance coverageAble to effectively deal with changeUnderstand the patients benefits throughout the patient admissionAble to complete projects within specific timetablesAble to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective mannerEducation/Experience/Licenses/Certifications:High school or GED diploma requiredMinimum of two years' experience in health-related authorization and eligibility requiredPhysical Requirements:You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job. However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.Requires the ability to write, dictate or use a keyboard to communicate directivesUtilizes proper body mechanics in multiple environmentsRequires the ability to function in multiple environmentsFLSA Status: Non-exemptEEO Status: Administrative Support WorkersBenefits + Perks of Joining the Team Select FamilyMedical, Dental, and Vision InsurancePaid Time Off and Paid Sick Time401(k)Referral ProgramPay Range: $18.00 - $22.00 / hour
Worksite address
phoenix, AZ, 85001, US
Who can apply
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