Insurance Auth Spec

Job description

The Insurance and Authorization Specialist is responsible for obtaining benefits and eligibility information and submitting authorization and subsequent re-authorization for patients requiring Enteral Nutrition or Oral Nutrition Supplements. For Part-Time positions, the standard hours will be determined at hire with a minimum of 17.5 hours and maximum of 35 hours with potential week to week fluctuation if desired. Job Responsibilities: - Run eligibility and benefits - Call insurance to go through individual HCPCs and Policy - Analyze paperwork to ensure that all required documentation has been received and that patient qualifies under the insurance guidelines - Work with local center or directly with referring provider if additional documentation is needed - Review paperwork for completion - Request authorization and follow up on authorization - Attach all documentation to the EMR system via a systematic naming process - Input thorough notes in EMR system - Communicate with the local center on authorization process - Use critical thinking skills and payer knowledge to determine what dates to submit for authorization for existing patients needing authorization - Work on getting pape...