Authorization Specialist

As an Authorization Specialist in Revenue Cycle Management (RCM), you play a critical role in ensuring timely and accurate processing of patient services by obtaining prior authorizations, referrals, and approvals from insurance companies. Your strong knowledge of insurance policies, excellent communication skills, and ability to efficiently navigate insurance portals are essential for supporting revenue integrity and minimizing claim denials. Key Responsibilities: - Verify patient insurance coverage and benefits to determine authorization requirements. - Collaborate with clinical staff, providers, and insurance companies to ensure timely submission and receipt of all necessary documentation. - Maintain accurate records of authorizations, denials, and appeals in the RCM system. - Communicate authorization status to internal departments such as scheduling, billing, and patient financial services. - Research and address insurance-related issues impacting prior authorizations. - Assist in appeals and resubmissions for denied or delayed authorizations. - Provide training and support to team members on authorization processes and system usage. - Contribute to enhancing authorization workflows and reducing delays in the revenue cycle. Qualifications: - High school diploma or equivalent required; Associates or Bachelors degree preferred. - Previous experience in healthcare authorization, billing, or revenue cycle management preferred. As an Authorization Specialist in Revenue Cycle Management, you will be an integral part of ensuring efficient and effective processing of patient services through obtaining prior authorizations and approvals from insurance companies. Your attention to detail and ability to collaborate with various stakeholders will contribute to the overall success of the revenue cycle.,