Authorization Specialist - Maitland, FL

Join a workplace recognized by Newsweek as America's Greatest Workplaces for Diversity for 2024. Advanced Dermatology and Cosmetic Surgery’s mission is to deliver the highest quality patient care and experience in dermatology and aesthetic services.  We are currently seeking candidates with exceptional customer service and clinical skills to join our team as an Authorization Specialist. We strive to create a career destination that feels more like family than work.  You will be working with a team of professionals for a well-known, highly regarded dermatology practice who puts our patients above all else.   

JOB DESCRIPTION:
The Authorization Specialist is responsible for the overall success of the insurance authorization procurement function. This individual provides good judgement in the coordination of all practice activities that contribute to assuring that all authorizations for treatment have been received prior to the patient’s appointment. This position requires knowledge insurance verification and insurance authorization processes. Knowledge of basic policies and procedures or functions of a multi-physician practice. Knowledge of HIPAA, Compliance, and OSHA regulations related to an outpatient practice. Knowledge of EMR and other clinic computer programs and applications. Requires skill in exercising a high degree of initiative, judgement, discretion, and decision-making to optimally achieve the goals of the position. Skill in establishing and maintaining effective working relationships with co-workers, physicians, leadership staff, patients, and the public. Ability to have knowledge of, organize and prioritize work effectively to meet the set goals, deadlines, and objectives of the position. This includes acquiring and documenting accurate patient information and meeting patient appointment readiness goals. Ability to communicate clearly and effectively both in writing and verbally. Knowledge of medical terminology CPT/ICD-10 preferred.

EDUCATION: High School, with 1-2 years’ experience in healthcare insurance billing and verification, collections and/or authorizations.

JOB TYPE: Full-time

·Review office schedules daily for patients requiring authorizations and begin authorization process at least 7 days in advance prior to patient visit, when possible.

·Accurately obtain visit and procedure authorizations through patient primary care physicians or patient insurance payers.

·Assure that authorization numbers are documented, and that primary care physician fax sheets are scanned into the EMR, as well as documented in Practice Plus and on the encounter form.

·For authorizations obtained through the patient’s insurance carrier, assure that the authorization numbers are documented in Practice Plus, as well as documented on the encounter form.

·Assure that the number of visits or treatments authorized are clearly documented in Allscripts and on the encounter form. Indicate the number of approved visits or treatments that are left from the original authorization is also documented.

·Notifying the appropriate staff members if treatment or service is denied and appointment needs to be cancelled or rescheduled.

·Assure that the file cases are packed and completed each day and ready to go to the practices.

·Accurately processes authorizations for add on patients from all offices.

·Highlights balances and assures that accurate co-pays and deductibles due are indicated on encounter forms.

·Double checks to ensure all demographic information on the encounter is accurate (i.e. name spelling, referring doctor, etc.)

·Utilizes patient chart on an as needed basis, accessing only information related to treatment, payment, and health operations.

·Keeping up to date on third party payer authorization requirement information.

·Maintains and adheres to the company’s HIPAA, Compliance, and OSHA regulations.

·Other duties as assigned.

Compensation/ Benefits:

• Career Advancement Opportunities.
• Paid holidays, vacation, floating holiday, AND personal time off
• Benefits packages, including medical, dental, STD, LTD, Life, and other voluntary benefit offerings (for employees working 30+ hours per week)
• 401(k) matching

   

  ADCS Clinics LLC participates in equal employment opportunities for all individuals and abides by EEOC and nondiscrimination provisions of all applicable federal, state, and local laws and regulations. All applicants must have authorization to work in the United States.