Insurance Authorization Specialist - McLeod Health : Job Details

Essential Job Responsibilities/Expectations

Insurance Authorization Specialist role is the secure third party payer authorization for services rendered by completing accurate and timely authorization requests. They are also responsible for communicating authorization follow up and outcomes in the patient medical record.

1. Responsible for insurance notification of McLeod Health Inpatient and Observation Admissions, Home Health and Hospice Services.

2. Collaborates with clinical team to send appropriate supporting documentation as required by payor.

3. Responsible for entering all required authorization information into appropriate system.

4. Responsible for communicating exhaustion of benefits to staff as well as concurrent denial information.

5. Maintains and expands awareness of preauthorization services for insurance coverage with all payors, investigating for potential coverage that may not have been provided, obtaining prior authorization for services to be performed and necessary documentation to ensure proper payment.

6. Assist with denial workflow and communication with physician advisor team.

7. Assist with UM fax line and voicemail.

8. Performs all other duties as assigned

Job Requirements

Qualifications /Training:

* One year of prior office experience in healthcare setting and/or related work experience.

Licenses/Certifications/Registrations/Education:

* Minimum of a High school diploma required from an accredited school

Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.

If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. We are an equal opportunity employer.