AUTHORIZATION SPECIALIST

Job Description

An authorization specialist usually works for a company that deals with insurance claims, such as a hospital, automotive shop, or private medical practice. The authorization specialist will take insurance information from clients and will determine if authorization is necessary for the services that are needed.

The specialist may also collect any copay that is due from the patient, or he she may make payment arrangements. Then the authorization specialist will gather all the necessary paperwork and will contact the insurance company involved. This contact may be made by phone, mail, or electronic communications, so it is important to be proficient in all of these modes. Customer service skills are also essential. Sometimes, preauthorization of services may be carried out, in order to make sure that the services that the client needs are covered under the insurance policy. It is also important to have strong knowledge of what the organization offers, so that questions from the client can be answered in an accurate and knowledgeable manner. When working in the medical field, some jobs will require the authorization specialist to be proficient with medical coding, such as CPT and ICD-9. Strong computer skills are usually required for this job.

Data entry skills and strong typing skills may be needed. Some filing and other organization duties may be carried out by the specialist. In some cases, the authorization specialist will also have front desk duties, such as greeting clients, answering the phone, and scheduling appointments. Some employers may prefer candidates who have bachelor’s degrees in business or a related field.

MUST HAVE at least 2 years experience.

ESSENTIAL DUTIES • Interview and assist patients with authorization documents, as appropriate.

• Maintain appropriate logs or reports according to professional, state and federal requirements.

• Monitor and track patient authorizations, informing supervisor of any expired dates.

• Ensure payment for services by verifying benefits with insurance provider.

• Obtain, review and input insurance authorization and referrals prior to patient services.