Hospital Authorization Specialist II

Job not on LinkedIn

🔥 12 hours ago

🏈 Alabama, Colorado, +14 more states – Remote

🏈 Alabama – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote 🍑 Georgia – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 25%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 21 days.
• 48 open roles for a team of 91.
• No salary listed.

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Center for Health Care Strategies

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1998

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Center for Health Care Strategies is a U. S. -based organization dedicated to improving the healthcare system to achieve better and more equitable outcomes, particularly for those served by Medicaid. The center focuses on issues like complex health and social needs, mental health, substance use, and aging and disability. It emphasizes cross-sector partnerships, community engagement, and health equity to transform the delivery system and promote value-based payments. The organization also supports leadership and capacity building efforts to drive system reform, including integrating Medicare and Medicaid services and advocating for trauma-informed care and primary care innovation.

📋 Description

• Obtain authorizations for hospital-based scheduled services and physician-based appointments • Initiate authorizations, follow up, monitor add-ons, and update authorizations for changes • Complete authorizations within department guidelines and payer requirements • Use available resources to complete authorization requests and verify eligibility • Interpret benefits to complete estimates and explain information to patients and families • Ensure authorization and notification requests are timely and properly documented • Review appointment add-ons, service changes, date changes, and patient class changes • Follow administrative review processes for cases lacking authorization within standard timeframes • Review clinical documentation and submit required information to payers • Document communications with payers, physicians, and families • Collaborate with business, financial, transport, cost estimation, managed care, utilization review, physician authorization, and other departments • Participate in daily departmental huddles and report payer issues, workflow barriers, and risks to reimbursement or service delivery • Build and maintain professional relationships with specialty departments • Assist with training on new processes

🎯 Requirements

• Authorization experience required • High School Diploma required • 1-3 years of job related experience required • Revenue Cycle related certification (e.g., CRCR) preferred • Applicants must reside in Alabama, Colorado, Delaware, the District of Columbia, Florida, Georgia, Illinois, Maryland, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or Virginia • Ability to request and obtain preauthorization for assigned specialties and cover other specialties, workqueues, preadmissions, and estimates • Ability to interpret benefits and verify eligibility, demographics, insurance coverage, and financial responsibility • Ability to review clinical documentation and payer clinical guidelines • Ability to use payer tools to determine authorization requirements • Ability to document communications according to standardized requirements • Effective written and verbal communication skills • Ability to work effectively in a virtual team environment, problem-solve, stay organized, and seek assistance when needed • Ability to provide excellent, empathetic customer service

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