Authorization Associate

The Authorization Associate is responsible for all aspects of the authorization process for patients. Responsible for inputting, maintaining, and bringing authorizations to resolution in a timely manner. Ensures that the system is up-to-date by inputting approved authorizations and scanned paper notes. Works under supervision of the insurance verification supervisor. This position maintains a high level of communication skills, confidentiality, attention to detail, & professionalism.

Working Hours-Night shift(8pm-5:30am)-(Mon-Fri)

ESSENTIAL FUNCTIONS: To perform this job successfully, an individual must be able to perform each essential function satisfactorily 1. Inputs authorization requests per guidelines and according to defined time and accuracy standards.

2. Process request that are approved, denied or deferred and bring them to resolution.

3. Responsible for Authorization maintenance, tracking and follow up.

4. Responsible for Deferred authorization maintenance, tracking and follow up.

5. Responsible for entering approved authorizations in the system.

6. Responsible for scanning paper notes into the system.

7. Maintains effective communication with management, co-workers, and physicians.

8. Inputs authorization requests per guidelines and according to defined time and accuracy standards.

9. Process request that are approved, denied or deferred and bring them to resolution.

10. Responsible for Authorization maintenance, tracking and follow up.

11. Responsible for Deferred authorization maintenance, tracking and follow up.

12. Responsible for entering approved authorizations in the system.

13. Responsible for scanning paper notes into the system.

14. Maintains effective communication with management, co-workers, and physicians.

15. Performs other related duties as needed.

QUALIFICATION GUIDELINES:
REQUIRED: High school diploma, GED or equivalent. Experience working with insurance companies.
DESIRABLE: Experience in the Ophthalmic or Optometric Industry. Knowledge about HMO insurances and authorization submission.
CERTIFICATES/LICENSES/REGISTRATIONS:

• None

KNOWLEDGE/SKILLS/ABILITIES/TALENTS:

• Must have thorough working knowledge of different types of coverage and policies.
• Must be a fast learner with excellent multitasking skills.
• Must be detail-oriented and organized to maintain accurate patient insurance records.
• Ability to focus and work quickly since verification process needs to be done in a timely manner.
• Team player and contributor coupled with excellent communication and interpersonal skills (oral and written) to maintain communication with management, co-workers, and physicians.
• Ability to draw valid conclusions, apply sound judgment in making decisions, and to make decisions under pressure.
• Ability to interpret and apply policies and procedures.
• Must address others professionally and respectfully by actions, words and deeds.
• Displays independent judgment by willingness to make timely and accurate decisions based on available information that is sometimes vague or limited in nature.
• Ability to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the clinic.