Insurance Authorization Specialist II

🕒 Ontem

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🔒 Seguros

🚫👨‍🎓 Sem graduação necessária

🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of WVU Medicine

WVU Medicine

10.000+ funcionários

⚕️ Seguro de Saúde

Healthcare Insurance

WVU Medicine é um sistema de saúde abrangente afiliado à West Virginia University, fornecendo serviços médicos através de uma rede de hospitais em todo o estado da Virgínia Ocidental. O sistema inclui instalações notáveis como o J. W. Ruby Memorial Hospital, WVU Medicine Children's, e vários outros centros médicos regionais. WVU Medicine oferece uma ampla gama de serviços de saúde, incluindo tratamentos médicos especializados e avançados, como cirurgia cardíaca robótica. Também está envolvido na educação médica, pesquisa e iniciativas de saúde comunitária, enfatizando a missão de fornecer cuidados de alta qualidade às comunidades que serve.

Descrição

• Obtaining authorizations for elective procedures, services, and tests • Coding cases and reviewing clinical documentation • Escalating financial clearance risks as appropriate • Driving key goals of securing reimbursement and minimizing organizational write-offs • Ensuring timely follow-up on submitted authorization requests • Reviewing and interpreting medical record documentation during the authorization process • Assisting with denial management issues and obtaining retro-authorizations as needed • Maintaining compliance with departmental quality standards

🎯 Requisitos

• High school graduate or equivalent with 2 years working experience in a medical environment • Associate’s degree and 1 year of experience in a medical environment required • 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes • Understanding of authorization processes, insurance guidelines, and third-party payors • Proficiency in Microsoft Office applications • Excellent communication and interpersonal skills • Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail • Basic computer skills

🏖️ Benefícios

• Health insurance • 401(k) matching • Flexible work arrangements • Professional development opportunities

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