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.
Qualifications: - 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).
Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member’s base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).