Authorization Specialist bei Stamford Health, Inc.
Stamford Health, Inc. · Norwalk, Vereinigte Staaten Von Amerika · Onsite
- Optionales Büro in Norwalk
MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:
Proactive verification and/or authorizations for insurance approval for scheduled and non-scheduled performed radiological exams.
Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes.
Actively communicates with technologists throughout the work day regarding status of authorization for scheduled exams (e.g.., communicate need for reschedule and/or cancellation if authorization not in-hand).
Actively communicates with technologists throughout the work day regarding any changes from scheduled exams to exams to be performed (based on established protocols) and communicating changes to referring providers, as well as ensuring acquisition of accurate authorizations.
Direct liaison to referring provider’s offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements. Will be located on-site, where available, to allow for face-to-face interactions with patients and/or referring providers when necessary.
Active participation in development of on-going process improvements related to authorization management processes.
7. Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams. Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information. Produces and distributes required forms with accurate patient information.
- Attends scheduled staff meetings, in service education opportunities and participates in continuing education programs. Formulates and maintains effective working relationships with employees and other managers of the health care team.
- Respects and protects the patient’s rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patient’s best interests with full consideration of their legal rights. Displays a positive attitude when interacting with provider’s office staff, providers and fellow employees.
QUALIFICATIONS/REQUIREMENTS:
High School Graduate or equivalent.
Medical and computer background.
Accurate typing skills.
Proficient in Microsoft Outlook, Word and Excel.
Demonstrates tact and understanding when dealing with patients and staff.
Displays a positive attitude at all times.
Ensures and promotes high quality customer service at all times while demonstrating professional work behavior.
Performs other related duties as assigned or requested in order to maintain a high level of service.
Accepts constructive criticism and responds appropriately.
Effectively communicates with supervisors and management regarding any issues or concerns.
- Complies with departmental and organizational policies and procedures.
Completes required continuous training and education, including department specific requirements.
- Must be able to effectively interact and communicate with people in varied situations.
Must be able to communicate articulately and comprehend written and verbal communications.
