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Medical Authorization Specialist

Company: Ivy Rehab
Location: Rock Hill
Posted on: January 11, 2022

Job Description:

Insurance Verification & Authorization Specialist

About Ivy Rehab

The Ivy Rehab Network was founded in 2003, and over the past 18 years it has grown into a leading national provider of outpatient physical, occupational, and speech therapy services. We are one of the largest, fastest growing physical therapy companies in the country. At Ivy Rehab we are all about the people and are excited to bring more talent to our team. We are a values-based community of professionals that are committed to high performance and dedicated to Caring, Serving, and Growing together.

Job Description

The Insurance Verification and Authorization Specialist will be responsible for validating insurance eligibility and coverage, coordination of benefits, and authorization/precertification for services in an outpatient therapy setting. The ideal candidate will not only ensure a positive experience for patients, providers, and fellow teammates, but will also minimize the risk of lost revenue and contribute to faster and more efficient reimbursement.

Responsibilities

* Contacts Insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information.
* Accurately enters required information in EMR to include therapy benefit details, length of authorization and total number of visits. Documents appropriate level of detail to maintain a record of activities.
* Requests, follows up and secures authorizations prior to and during treatment episode.
* Accurately documents patient account to reflect all actions taken regarding status of eligibility/authorizations.
* Documents patient responsibility to include any co-pay, co-insurance and outstanding deductible and notes account accordingly.
* Monitor add-on appointments to ensure insurance is verified and authorizations are obtained.
* Establishes and maintains a professional and collaborative relationship with all staff to resolve problems and increase knowledge of insurance requirements.
* Performs monthly verification for all Medicaid patients.
* Annual reverification for all existing accounts
* Performs other duties as assigned by leadership staff.
* Cross trains and assists as needed in other departments (i.e., front office - answering phones, scheduling patients, faxing, maintaining accounts)
* Maintains patient record confidentiality in accordance with HIPAA, complying with practice policies and procedures.

Qualifications:

* Prior experience working with Medicare, Medicaid, other government payers and commercial insurance in the therapy arena is a plus.
* Demonstrates flexibility in responding to priorities and organizational change.
* Demonstrates the ability to work under pressure and follow through on assignments despite setbacks.
* 2-3 years previous experience in pre-auth verification; experience with obtaining authorizations, referral coordination and patient services preferred.
* Ability to multi-task, prioritize needs to meet required timelines.
* Customer service experience required.
* Effective written and verbal communication skills.
* Strong data entry skills and ability to type with speed and accuracy. Strong computer and software skills.
* Ability to use standard office equipment to include copiers, fax machines, and other methods of electronic communications.
Associated topics: casualty, claim, claim adjuster, claimant, damage, fraud, insurance adjuster, insurance examiner, investigate, liability adjuster

Keywords: Ivy Rehab, Rock Hill , Medical Authorization Specialist, Other , Rock Hill, South Carolina

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