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Authorization Specialist / Head - U.S. Medical Billing
SLP-Tele
posted 18d ago
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Job Description
Job Description Authorization Specialist / Head U.S. Medical Billing
Position: Intake Specialist/Head
Department: Medical Billing / Revenue Cycle Management
Location: Work from Office
Reports To: RCM Manager
Department: Medical Billing / Revenue Cycle Management
Location: Work from Office
Reports To: RCM Manager
Job Summary:
The Authorization Specialist / Head U.S. Medical Billing is responsible for managing patient referrals, verifying insurance eligibility, obtaining prior authorizations/LOA, and ensuring all necessary documentation is collected for seamless billing and claims processing. This role requires excellent communication skills, attention to detail, and a deep understanding of medical billing procedures.
Key Responsibilities:
Referral Intake Processing:
- Receive and review patient referrals from providers or healthcare facilities.
- Verify patient demographics and insurance details in the system.
- Ensure all required documentation (insurance cards, physician orders, prescriptions, etc.) is obtained.
Insurance Verification Authorization:
- Verify patient eligibility and benefits with primary and secondary insurance.
- Obtain prior authorizations/LOA and approvals as required by the insurance provider.
- Track authorization status and follow up on pending requests.
- Communicate authorization approvals or denials to the relevant teams.
Data Entry Documentation:
- Accurately enter patient and insurance information into the billing system.
- Maintain up to date records of all referrals, authorizations, and eligibility checks.
- Ensure compliance with HIPAA and company policies regarding patient data security.
Coordination Communication:
- Act as a liaison between the billing team, providers, and insurance companies.
- Communicate with patients regarding insurance coverage, co pays, and out of pocket costs when necessary.
- Collaborate with the RCM team to resolve issues related to eligibility, benefits, and authorizations.
Requirements & Qualifications:
- Education: Bachelors or Masters degree.
- Experience: Minimum of 10 years of experience in med
Employment Type: Full Time, Permanent
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