Verification Authorization - Associate

Role Summary

Verification Authorization - Associate

Responsibilities

• Proficient in and exceeding job responsibilities of Verification/ Authorization Personnel –Specialist either through Caris or with a former employer in a similar industry.
• Identify ways to improve and promote quality and monitor your own work to ensure quality standards are met.
• Answers provider, facility and staff questions surrounding insurance authorization requirements.
• Manage and assign daily/weekly tasks based on business need.
• Occasional peer-to-peer training.

Qualifications

• Required:
  • High School degree or equivalent required.
  • 2+ Years of office setting experience.
  • Proficient in MS Office (Word, Excel, Outlook)
  • Demonstrates solid time management skills and organization
  • Ability to work with minimal guidance; Proactive, motivated self-starter
  • Flexibility and proven ability to handle and manage frequent changes effectively and efficiently
  • Strong knowledge of insurance processing, guidelines and general laws related to all payers.
  • Proficient in clinical documentation review for alignment with insurance authorization requirements
  • Strong Problem-Solving skills
  • Maintains compliance with HIPPA and other healthcare regulations
  • Moderate knowledge of CPT, ICD-10

• Preferred:
  • Minimum bachelor's degree and 3 years of experience in a related industry or 5 years of experience in a related industry
  • Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
  • Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
  • Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization to achieve the desired results.
  • Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
  • Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

Skills

• Insurance processing knowledge
• Clinical documentation review
• Time management and organization
• Communication and teamwork
• Problem solving

Education

• High School diploma or equivalent (Required); Bachelor's degree preferred

Additional Requirements

• Physical demands: Ability to sit/stand for long periods, repetitive motion, lift up to 15 pounds; desk/cubicle environment
• Willingness to work shift work and overtime; occasional weekends/evenings/holidays