promptly Job descriptionAn Authorization Specialist in a medical billing company performs a key role in ensuring that medical services rendered by healthcare providers are properly authorized by insurance companies or other payers. Here's a detailed job description for such a position:Verifying Insurance Information: The Authorization Specialist is responsible for verifying patients' insurance coverage details, including eligibility, benefits, and any specific requirements related to authorization for medical services.Requesting Authorizations: They initiate the process of obtaining pre-authorizations or pre-certifications from insurance companies for medical procedures, treatments, diagnostic tests, durable medical equipment, or other services as required.Reviewing Medical Necessity: Authorization Specialists assess medical documentation provided by healthcare providers to determine the medical necessity of requested services, ensuring they meet insurance company criteria for coverage.Submitting Authorization Requests: They compile and submit authorization requests to insurance companies electronically or via other designated channels, ensuring all required documentation is included to support the request.Following Up on Authorization Status: Authorization Specialists monitor the status of authorization requests, tracking approvals, denials, or pending responses from insurance companies. They follow up as necessary to expedite the process and address any issues or discrepancies.Resolving Authorization Issues: They work closely with insurance company representatives to resolve authorization-related issues, such as denials or requests for additional information, by providing necessary documentation and advocating for the patient's needs.Maintaining Documentation: Authorization Specialists maintain accurate and detailed records of all authorization requests, approvals, denials, and related communications in the billing system or electronic health record (EHR) software.Collaborating with Billing Team: They collaborate with the billing team to ensure that authorized services are billed accurately and in a timely manner, following established coding and billing guidelines.Providing Education and Support: Authorization Specialists may provide education and support to healthcare providers and administrative staff regarding the authorization process, insurance requirements, and documentation best practices.Compliance and Regulatory Adherence: They ensure compliance with healthcare regulations, including HIPAA privacy rules, and adhere to industry standards and best practices related to authorization processes and medical billing.Staying Updated: Authorization specialists stay informed about changes in insurance policies, billing regulations, and industry trends to effectively navigate the authorization process and support the company's operations.Overall, authorization specialists play a critical role in streamlining the authorization process, optimizing reimbursement for healthcare services, and ensuring patient access to necessary medical treatments while maintaining compliance with regulatory requirements.Job Type: Full-timePay: 21,000.00 - 35,000.00 per monthBenefits:Provident FundSchedule:Monday to FridayNight shiftAfternoon shift US shiftSupplemental Pay:Joining bonusPerformance bonusExperience:total work: 1 year (Preferred)Work Location: In personSend your CV at WhatsApp +91 8320127619