CENTRAL AUTHORIZATION SPECIALIST

<p>**RESPONSIBILITIES:**</p><ul><li>Facilitate the successful procurement of insurance authorizations for ordered procedures and post-operative care across all sites of practice</li><li>Validate obtained authorizations and provide education to ordering physician offices and authorization procurement staff to ensure quality and consistency</li><li>Gather feedback from coding, billing, and denial management resources and distribute findings to ordering physicians and procurement staff to drive continuous improvement</li><li>Apply process improvement methodologies to identify and address performance gaps in workflow, education, and authorization processes</li><li>Manage an assigned caseload and plan effectively to meet authorization procurement demands while supporting resources</li><li>Serve as a centralized subject matter expert on precertification and payor authorization processes for designated specialties</li><li>Exercise sound judgment and collaborate effectively with physicians, payors, patients, and all levels of management and clinical staff</li></ul> <p>**REQUIRED QUALIFICATIONS:**</p><ul><li>High school diploma or equivalent; minimum 3-5 years of related experience in a medical clinic, hospital, or corporate setting</li><li>Two years of experience in healthcare insurance verification and/or billing</li><li>Proficiency with computer systems and applications</li><li>Knowledge of medical coding and clinical terminology</li><li>Ability to interpret clinical notes and insurance documentation</li><li>Strong organizational and time management skills with ability to prioritize multiple tasks</li><li>Excellent oral and written communication skills</li><li>Strong analytical and data management capabilities</li><li>Ability to work independently and exercise sound judgment with physicians, payors, and patients</li><li>Ability to collaborate effectively with all levels of management and clinical staff</li></ul><p>**PREFERRED QUALIFICATIONS:**</p><ul><li>Experience in a medical or surgical specialty clinic</li><li>Knowledge of hospital operations, utilization management, case management, and managed care reimbursement</li><li>Understanding of revenue cycle processes including billing, coding, charge capture, and reimbursement</li><li>Coursework or certification in business, healthcare administration, or related field</li><li>Strong negotiation and interpersonal communication skills</li></ul>