Medical Authorizations Clerk
About The Position
FlexStaff is hiring a Medical Authorization Clerk on a temp to perm basis for our client in there Port Jefferson location. Shift times/days: Monday-Friday, 8-4:30pm or 8:30-5pm Pay: $23.00 - $25.00 per hour (occasional overtime as needed) The Authorizations Clerk - is responsible for obtaining prior authorization approvals from insurance companies for patient infusions, medications, and medical/radiology tests. This role involves interacting with insurance providers, healthcare professionals, and patients to ensure timely approvals, while maintaining compliance with insurance policies and healthcare regulations. The Authorizations Clerk plays a critical role in ensuring that patients receive the necessary treatments and services without unnecessary delays, facilitating smooth operations within the healthcare practice. Work with healthcare providers to gather necessary clinical information and documentation to ensure authorization requests are complete and properly substantiated. Address any issues or delays in the authorization process, helping patients and providers resolve concerns quickly and efficiently. Compliance and Documentation Ensure all authorizations are compliant with insurance policies, industry standards, and regulatory requirements. Maintain thorough and accurate documentation of all authorization activities, including the submission and approval process, for auditing and compliance purposes. Stay up to date with changes in insurance policies, guidelines, and regulations related to medical treatments, medications, and testing. Appeals and Denial Management Review and analyze denied authorization requests, working with healthcare providers to appeal denials or re-submit information as necessary. Track and document the appeals process, ensuring that all required information is provided to insurance companies in a timely manner. Support the billing department with any additional information or documentation needed to process claims after authorization has been obtained.
Requirements
- High school diploma or equivalent (associate's degree or healthcare-related certification is a plus).
- Previous experience in medical insurance authorizations, medical billing, or healthcare administration is preferred.
- Knowledge of medical terminology, insurance processes, and healthcare regulations (especially regarding authorizations and approvals).
Nice To Haves
- associate's degree or healthcare-related certification
Responsibilities
- Work with healthcare providers to gather necessary clinical information and documentation to ensure authorization requests are complete and properly substantiated.
- Address any issues or delays in the authorization process, helping patients and providers resolve concerns quickly and efficiently.
- Ensure all authorizations are compliant with insurance policies, industry standards, and regulatory requirements.
- Maintain thorough and accurate documentation of all authorization activities, including the submission and approval process, for auditing and compliance purposes.
- Stay up to date with changes in insurance policies, guidelines, and regulations related to medical treatments, medications, and testing.
- Review and analyze denied authorization requests, working with healthcare providers to appeal denials or re-submit information as necessary.
- Track and document the appeals process, ensuring that all required information is provided to insurance companies in a timely manner.
- Support the billing department with any additional information or documentation needed to process claims after authorization has been obtained.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
