Verification Authorization Associate

Position Summary

Our Verification Authorization Associates are responsible for verifying active insurance coverage, obtaining all necessary facility and specimen collection information to bill in accordance with CMS regulations as well as contacting insurance companies to secure preauthorization required for patients to receive our services and contacting facilities for Medical Records when necessary. We need individuals to ensure information obtained is complete and accurate, follow up on requests, and apply acquired knowledge of Medicare, Medicaid, and other Third-Party Payer requirements.

Job Responsibilities

• Proficient in and exceeding job responsibilities of Verification/ Authorization Personnel -Specialist either through Caris or with a former employer in a similar industry.
• Identify ways to improve and promote quality and monitor your own work to ensure quality standards are met.
• Answers provider, facility and staff questions surrounding insurance authorization requirements.
• Manage and assign daily/weekly tasks based on business need.
• Occasional peer-to-peer training.

Required Qualifications

• High School degree or equivalent required.
• 2+ Years of office setting experience.
• Proficient in MS Office (Word, Excel, Outlook)
• Demonstrates solid time management skills and organization
• Ability to work with minimal guidance; Proactive, motivated self-starter
• Flexibility and proven ability to handle and manage frequent changes effectively and efficiently
• Strong knowledge of insurance processing, guidelines and general laws related to all payers.
• Proficient in clinical documentation review for alignment with insurance authorization requirements
• Strong Problem-Solving skills
• Maintains compliance with HIPPA and other healthcare regulations
• Moderate knowledge of CPT, ICD-10

Preferred Qualifications

• Minimum bachelor's degree and 3 years of experience in a related industry or 5 years of experience in a related industry
• Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
• Drive for Results (Service, Quality, and Continuous Improvement) - Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
• Communication - Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization to achieve the desired results.
• Teamwork - Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
• Customer Service Focus - Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.