Hybrid Authorization and Coding Specialist bei Graham Hospital District

Description

Job Summary:

The Authorization and Coding Specialist is responsible for reviewing insurance information, obtaining prior authorizations, and for ensuring proper coding and billing of claims for assigned specialty clinics.

Supervisory Responsibilities:

• May be involved in training staff on authorization, coding, and billing procedures

Duties/Responsibilities:

• Confirm insurance benefit and eligibility for patients
• Complete authorizations and referrals for services, including appointments and procedures
• Review patient’s medical history and insurance coverage for approval
• Contact referring physicians for additional information as needed
• Input patient information into EMR, accurately and timely
• Assist with, complete, and provide coding and billing documentation to ensure accurate coding and billing practices to maximize revenue and minimize claim denials
• Assist with other clerical tasks as needed to include serving in a receptionist role
• Answer inquiries from patients and healthcare providers
• Collect co-pays and co-insurance for approved services
• Maintain compliance with relevant regulations, including HIPAA, and payer-specific guidelines
• Perform other related duties to benefit the mission of the organization

Requirements

Required Skills/Abilities: 

• Knowledge of insurance authorization procedures and requirements
• Knowledge of medical terminology
• Knowledge of CPT and ICD10 coding
• Knowledge of basic math skills
• Strong written and verbal communication skills
• Intermediate computer skills, including but not limited to: Microsoft Office, electronic medical record, and email
• Strong command of / proficient in spoken and written English
• Strong attention to detail
• Ability to multi-task with multiple interruptions

Education and Experience:

• Highschool diploma or GED required
• Minimum two years patient account experience
• Certification in coding and billing strongly preferred

Physical and Mental Requirements: 

• Prolonged periods sitting at a desk and working on a computer
• Must be able to lift up to 25 pounds at times
• Must be able to navigate various departments of the organization’s physical premises
• Sufficient hearing, vision, and dexterity to perform duties safely
• Stress Level: Moderate to High

OSHA Classification:

• Category III: Tasks that involve no exposure to blood, body fluids, or tissues, and Category I tasks are not a condition of employment.
• The normal work routine involves no exposure to blood, body fluids, or tissues (although situations can be imagined or hypothesized under which anyone, anywhere might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first-aid or to be potentially exposed in some other way. Tasks that involve handling implements or utensils, use of public or shared bathroom facilities or telephone, and personal contacts such as handshaking are Category III tasks.