Authorization Specialist

Duties and Responsibilities

• Provide exceptional service every time.
• Meet or exceed annual performance indicators as outlined by organizational leadership.
• Complete assigned tasks and worklists in a timely manner.
• Ensure scheduled dates of service for equipment rentals bill on time and correctly.
• Ensure supply orders can be placed and delivered to the patients when eligible for new supplies.
• Work with providers and patients to obtain necessary and current medical documentation.
• Stay up to date on insurance guidelines and their authorization and billing requirements.
• Ensure patient charts are up to date and accurate.
• Update patient insurance policies and adjust sales orders as needed.
• Perform basic billing functions including but not limited to credit adjustments and recalculation of billing dates of service to ensure sales orders bill correctly.
• Verify patients’ insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients’ insurance policies and costs.
• Facilitate process for requesting prior authorizations for Commercial, Medicaid, and Medicare Policies.
• Work with providers and patients to help them understand requirements for payor coverage including but not limited to: Authorization and compliance requirements Appeals for denied services / claims
• Process payment for services rendered.
• Evaluate and/or escalate patient accounts that do not meet insurance or provider guidelines.
• Troubleshoot equipment issues with patients.
• Refer issues to the Reliable clinical team, manufacturer’s care teams or referring provider as needed.
• Verify equipment scheduled to be returned or picked up, to ensure appropriate billing to patient and/or insurance.
• Actively participate in meetings as necessary.
• Perform other duties and special projects as assigned and directed.

Basic Qualifications

• 18 years of age or older
• Must be eligible to work in the United States and not require work authorization from us now or in the future
• Associate’s degree required or 2 years of relevant (authorization, claims, billing) experience

Required Skills

• Demonstrates effective problem solving.
• Listens attentively to people’ ideas and concerns.
• Makes decisions in a timely manner when the options are clear and there is little pressure or risk.
• Maintains balance through unexpected circumstances.
• Acts without being asked or required to do so.
• Exercises excellent judgment in all aspects of the execution of job duties.
• Effective and professional verbal and written communication abilities.
• Seeks to improve in all aspects of work performance.
• Responds to internal and external inquiries in a timely manner.
• Excellent customer service skills; especially in high intensity situations.
• Strong attention to detail.
• Proficient in the use of computer applications (especially Microsoft Office Suite).
• Ability to work independently.
• Ability to work in collaboration with others.
• Ability to prioritize and complete work amidst interruptions in a busy work area.
• Ability to comply with internal and industry-imposed guidelines/regulations.