Authorization Specialist
Company: Westchester Medical Center
Location: Montebello
Posted on: May 13, 2022
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Job Description:
Location field must contain 'city, state' or a zip code to
perform a radius search (e.g., Denver, CO or 46122 ). City and
state must be separated by a comma followed by a space (e.g.,
Houston, TX )Position: Full TimeHours: 8-4Shift: DaysPosted Date:
Apr 27, 2022Apply NowThe Authorization Specialist is responsible
for performing complex clerical procedures related to verifying
insurance information and obtaining authorization for inpatient
admissions and specialized clinical procedures and treatments in
accordance with established rules procedures, specified time
frames, and regulatory requirements. The Specialist processes
clinical information in a timely manner to prevent treatment delays
and to avoid denials from third party payers and maintains
confidentiality of patient information.RESPONSIBILITIES:Enters and
retrieves information from various automated systems and prepares
specialized reports.Collects demographic and insurance data and
enters accurately in to specialized automated systems.Prepares,
reviews for completion, and maintains required documents in
accordance with established procedures, time frames and regulatory
requirements.Makes contacts to obtain missing information for
incomplete forms.Advises patients and clinical staff of problems
with insurance authorizations and re-submits requests with
additional or revised information.Verifies insurance eligibility
with third party payers using internet websites and RTE.Contacts
insurance providers to confirm level of benefits for inpatient
admissions.Responds to customer inquiries and provides
information.Serves as liaison between the physician's offices,
patients, case management department and Patient
Registration.Follows up with patients, physicians, clinical and
ancillary departments to ensure optimum delivery of
services.Communicates with case managers, hospital personnel, and
external agencies to provide information or resolve
discrepancies.Reviews daily discharge statistics in ConnectCare
software.QUALIFICATIONS/REQUIREMENTS:Two to three years of clerical
experience in health care field or related area required;
experience in an outpatient setting preferred.EDUCATION:A high
school diploma or equivalency required.OTHER:If applicable, the
individual performing this job may reasonably anticipate coming
into contact with human blood and other potentially infectious
materials. Individuals in this position are required to exercise
universal precautions, use personal protective equipment and
devices, and learn the policies concerning infection control.About
Us:Apply Now
Keywords: Westchester Medical Center, Montebello , Authorization Specialist, Other , Montebello, California
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