[Hiring] Hospital Authorization Specialist @Cardiac Study Center

Role Description

The Hospital Authorization Specialist is a vital role ensuring the seamless authorization of hospital procedures for our patients. This role involves coordinating with providers, insurance companies, and hospital staff to secure necessary pre-authorizations, address denials, and maintain accurate records.

Your Day-to-Day Work:

• Review and manage daily hospital procedure schedules to identify pre-authorization needs.
• Obtain authorizations from insurance companies using phone, fax, and online portals.
• Verify that CPT and ICD-10 codes align with scheduled procedures and insurance requirements.
• Collaborate with providers to handle peer-to-peer requests and appeal denied authorizations.
• Communicate with patients about procedure approvals, reschedules, or cancellations.
• Read medical charts to ensure procedures align with providers' plans.
• Work closely with hospital pre-service teams to confirm all authorizations are accurate and complete.
• Maintain up-to-date knowledge of insurance guidelines and ensure compliance with all HIPAA regulations.

Qualifications

• High School Diploma or GED.
• 1-3 years of experience in medical authorization, healthcare administration, or a related field.
• Strong understanding of medical terminology and insurance guidelines.
• Excellent attention to detail and organizational skills.

Requirements

• Familiarity with ICD-10 and CPT coding.
• Prior experience with pre-authorizations or appeals processes.
• Experience using healthcare systems like EPIC or other EMR platforms.

Benefits

• Comprehensive health insurance (with zero-cost premiums).
• Dental & vision plans.
• FSA/HSA options.
• Retirement matching.
• Paid vacation & floating holidays.
• Mental health support, and more!