Role Description
Under limited supervision the Insurance Authorization Specialist reviews and manages the benefits and authorizations for hospitals and physicians. This type of specialist acts as an intermediary between the medical institution, patients, and the insurance agency. They assist in verifying benefits and obtaining authorizations for inpatient and outpatient services.
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Maintain work queue assigned by the client
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Verify benefits and secure authorization for inpatient and outpatient services
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Perform other duties as directed
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Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance
Qualifications
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Knowledge of medical and insurance terminology such as CPT, ICD-9, ICD-10, HCPCS, co-pay, deductible or co-insurance
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Minimum 1-2 years’ experience in Medical Billing/Coding
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Experience with standard office software products
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High School diploma or equivalent
Requirements
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Ability to prioritize and multi-task in a fast-paced, changing environment
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Demonstrate ability to work in all work types and specialties
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Demonstrate ability to self-motivate, set goals, and meet deadlines
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Demonstrate leadership, mentoring, and interpersonal skills
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Demonstrate excellent presentation, verbal, and written communication skills
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Ability to develop and maintain relationships with key business partners by building personal credibility and trust
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Maintain courteous and professional working relationships with employees at all levels of the organization
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Work in accordance with corporate and organizational security policies and procedures
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Demonstrate excellent analytical, critical thinking and problem-solving skills
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Manage the Individual KRA’s as per the provided metrics
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Understand client requirements and specifications of the project and ensure targeted collections are met on a daily/monthly basis
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Meet the productivity targets of clients within the stipulated time
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Ensure timely follow-up on pending claims and prepare and maintain individual status reports
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Skill in operating a personal computer and utilizing a variety of software applications is essential
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Knowledge of coding convention and rules established by AHIMA, AMA, AHA, and CMS is an added advantage
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Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records is an added advantage
Benefits
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Comprehensive benefits package including health, dental, and vision coverage
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Voluntary insurance options
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401(k) plan with employer match
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Professional development opportunities
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Paid time off and holiday pay
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Opportunity to participate in bonus programs, commissions, or other variable incentive plans
Company Description
Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines.