Authorization Specialist II

Job Summary

A company is looking for an Authorization Specialist to obtain surgical prior authorizations for surgical services.

Key Responsibilities

• Obtain and track authorizations/re-authorizations for patients according to insurance policies
• Initiate Peer to Peer discussions with payers and collaborate with providers to secure letters of Medical Necessity
• Monitor authorization work queues and troubleshoot authorization denials

Required Qualifications

• Associate degree preferred
• Preferred certification in CCS, CCS-P, CPC, or specialty coding
• Three or more years of experience in a healthcare environment, preferably with prior authorization experience
• Strong understanding of HIPAA laws and managed care reimbursement requirements
• Proficient in Microsoft Office applications and experience with EMR systems