CENTRAL AUTHORIZATION SPECIALIST

<p>**Key Responsibilities:**</p><ul><li>Centrally facilitate and validate the procurement of insurance authorizations for ordered procedures and post-operative care, ensuring accuracy and timeliness</li><li>Provide subject matter expertise in precertification and payor authorization processes to ordering physician offices and authorization procurement staff</li><li>Deliver continuous education and performance feedback to multi-disciplinary teams to promote process improvements and cost management</li><li>Identify workflow inefficiencies and performance gaps, implementing process improvement methodologies to enhance outcomes</li><li>Manage designated caseload effectively, serving as a standardized resource across all practice sites to ensure consistent authorization procurement</li><li>Obtain feedback from coding, billing, and denial management resources and distribute relevant findings to physicians and staff for continuous improvement</li></ul> <p>**REQUIRED:**</p><ul><li>High school diploma or equivalent; minimum 3-5 years of related experience in a medical clinic, hospital, or corporate healthcare setting</li><li>2+ years of healthcare insurance verification and/or billing experience</li><li>Proficiency with computer systems and healthcare software applications</li><li>Knowledge of medical coding, clinical terminology, and insurance authorization processes</li><li>Ability to interpret clinical notes and insurance documentation</li><li>Strong organizational, time management, and prioritization skills</li><li>Excellent written and oral communication skills</li><li>Ability to work independently and exercise sound judgment with physicians, payors, and patients</li></ul><p>**PREFERRED:**</p><ul><li>Experience in a medical or surgical specialty clinic</li><li>Knowledge of utilization management and managed care reimbursement</li><li>Strong analytical and data management capabilities</li><li>Experience negotiating with clinical and finance personnel</li></ul>