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Authorization Specialist

Job Category: BILLING
Job Title: Authorization Specialist
Employee Type: Non-Exempt FT
Location: Williamsville, NY

Position Summary:
Responsible for accurately and efficiently performing billing duties to ensure proper and timely payment is received from insurance carriers and patients.
Essential Functions:
Obtain and ensure prior authorizations are in place for proper exam and well documented for all exams requiring prior authorization as noted by insurance carrier within 48 hours of exam.Handle external communication (verbal and written) to patients, referring physicians, insurances as necessary to obtain information, authorizations or clarifications.Ensure correct coding, billing information is verified in advance of exam.Assist a wide range of individuals regarding authorization and billing situations with compassion both in person and on the telephone.Document Prior authorization updates via communication with referring Physician office regarding status of authorization.Notify appropriate departments of pending, approved and denied exams.Communicate effectively with patients and their family members, team members, supervisors, managers and Radiologists, establishing a good rapport.Consistently maintain a professional, positive and compassionate manner when handling billing inquiries and questions from patients.Provide interdepartmental communication and education of prior authorization requirements by exam and insurance.Communicate within and across departments, with patients, referring offices and insurances to obtain appropriate information required for prior authorization claims submission.Maintain an organized and efficient work area.Assist other authorization specialist as needed.Adhere to and uphold all HIPAA and New York State regulations regarding patient privacy as well as standards of ethics set forth by Windsong Radiology Group.All other temporary and/or permanent duties as assigned by Administrator or Manager.
2 years’ experience in medical or surgical related authorization, coding or billing.2 year business degree with 2 years’ experience in medical billing office; or High School diploma with 3 years’ experience in medical office.Strong knowledge of keyboarding, computers, business and/or office practices.Ability to quickly adapt to variety of software programs.Excellent customer service skills with ability to professionally communicate orally and in the written form.Requires manual dexterity for operating standard office equipment.Basic lifting as required, not to exceed 25 pounds.Must be able to sit for extended periods of time with the ability to maintain concentration and attention to detail.Ability to work flexible hours including evenings and Saturdays as well as ability to work additional hours as needed.
Work Environment:
Position is in a well-lighted, fast-paced, clean medical office environment.
Physical Requirements:
Must possess the physical and mental abilities to perform the tasks normally associated with the essential job functions such as stationary, mobility, operating machinery, convey and exchange information.
Manual dexterity to operate standard office machines/equipment such as computers, printers, multi-line phones, photocopiers, fax systems and calculators.
Windsong Radiology is an equal employment opportunity employer. Employment decisions are based on merit and business needs, and not on legally protected classes including but not limited to race, color, citizenship status, national origin, ancestry, gender, or expression whether or not such gender identity or expression differs from the employee’s physical sex as assigned at birth (including transgender status), sexual orientation, age, weight, religion, creed, physical or mental disability, predisposing genetic characteristics and information, marital status, familial status, domestic violence victim status, veteran status, military status, political affiliation, or any other factor and/or status protected by law. The policy applies to all areas of employment, including recruitment, hiring, training and career development, promotion, advancement, transfer, termination, layoff, compensation benefits, retirement, social and recreational programs and all other conditions and privileges of employment in accordance with applicable federal, state and local laws.