Job Description
Job Description
Department: Patient Accounts
Reports To: Director of Patient Accounts
Schedule: Monday - Friday, 9:00 AM - 5:00 PM
Position Summary:
Under the direction of the Director of Patient Accounts and in close coordination with the Billers, OPD Registrar/Scheduler, and Medical Records department, the Benefit Verification and Authorization Specialist is responsible for obtaining prior authorizations for all outpatient clinic and therapy services. This role ensures that all scheduled and rendered services are authorized and verified in compliance with payer requirements to support successful billing and collection outcomes.
The Specialist will manage daily tasks via insurance portals and phone communications, track and follow up on outstanding authorizations, and coordinate with the Medical Records team to obtain necessary documentation. This role will also serve as a backup for outpatient registration and scheduling when needed and provide customer service to patients regarding their benefits and authorizations.
Key Responsibilities:
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Obtain and track prior authorizations for all outpatient clinic and therapy services.
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Submit authorization requests through insurance portals and phone calls.
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Verify patient insurance benefits and communicate coverage details to patients and clinical teams.
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Monitor, track, and follow up on outstanding or expiring authorizations to ensure continuity of care.
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Collaborate with the Medical Records department to gather required documentation for submissions.
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Work closely with Patient Accounts to support accurate billing and reduce denials.
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Provide customer service to patients regarding benefits, coverage, and authorizations.
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Serve as a backup to the Outpatient Registrar/Scheduler, including registration and scheduling functions.
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Maintain accurate and timely documentation in Meditech Expanse and other systems as required.
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Respond to urgent authorization requests in a fast-paced environment with multiple concurrent priorities.
Qualifications:
Education:
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High school diploma or equivalent required.
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Associate's or Bachelor's degree preferred.
Experience:
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Minimum of 3 years of direct experience in a hospital or outpatient setting handling prior authorizations.
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Knowledge of hospital reimbursement procedures and insurance authorization processes.
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Proficiency in CPT and Revenue Code use for authorization purposes.
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Prior experience with Meditech Expanse, Microsoft Office (Excel, Word, Outlook), and insurance portals.
Skills:
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Strong communication and interpersonal skills.
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High attention to detail with the ability to manage multiple tasks concurrently.
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Exceptional organizational and time management skills.
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Ability to work independently and collaboratively in a fast-paced environment.
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Bilingual (English/Spanish) a plus.
Why Join Us?
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Be part of a fast-growing and collaborative team.
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Enjoy a close-knit and supportive work environment.
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Gain long-term professional growth opportunities within the organization.
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
Company Description
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?