Authorization Specialist at USPI

Pittsburgh, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Jun, 26

Salary

0.0

Posted On

12 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Interacting With Payers, Obtaining Authorization, Investigating Insurance Coverage, Communication, Payor Requirements Knowledge, EHR Documentation, Denial Follow-up, Medical Records Management, Authorization Tracking, Verbal Communication, Written Communication, Interpersonal Communication

Industry

Description

Careers at Our Amazing Place. At The Children’s Institute of Pittsburgh, we’ve built our legacy on being amazing. After more than a century of the highest quality care and service to children and their families, we’re forever proud of our team members who don’t just make a career here – they make a difference. Job Title: Authorization Specialist Location: 1405 Shady Ave., Pittsburgh, PA 15217 Schedule: Monday – Friday, Full Time The Authorization Specialist is responsible for interacting with payers and physician offices to obtain referral/authorization for outpatient services delivered at all sites. The Authorization Specialist is responsible for investigating the insurance coverage for all clients to ensure payment. The specialist will act as the point person for communication related to insurance benefit coverage. Responsibilities * Obtain certified and re-certified care plans as required * Monitor and ensures certified care plans are returned for all patients active in care * Knowledgeable of payor requirements * Obtain hardcopy of all authorizations * Accurately input appropriate documentation in EHR * Process changes in information pertaining to demographic and insurance information * Follow-up on authorization denials * Maintain consistent communication with front desk, billing department, providers, and families regarding authorization benefits and service options * Track the movement and expiration of authorizations * Manage all aspects of medical records, which includes fulfilling medical record requests and bill record requestor * Provide authorization reports upon request Qualifications * High school diploma or equivalent is required * Three years relevant insurance experience * Must be knowledgeable of insurance protocols and providers across all service lines * Health care experience preferred * Strong, effective, and clear verbal, written and interpersonal communication skills * Has knowledge of commonly used concepts, practices, and procedures within health care field * Clearances Required: Act 73 FBI, Act 34 Criminal Clearance, and Act 33 Child Abuse Clearance Benefits Summary We're proud to offer generous benefits to our team members. Regular full-time team members are eligible for the following benefits: * Medical and Prescription insurance-Choice of two health plans and networks * Dental and Vision-Free coverage for team members. * Paid Time Off (PTO) and Holidays * Medical, Bereavement, Educational, & Personal Leaves * Parental leave (birth & adoption) paid-6 weeks * 403b Retirement Plan – pre-tax & Roth options; employer match after 1 year * Student Loan Refinancing Program * Public Service Loan Forgiveness Program – CI qualifies as non-profit * Education Assistance/Tuition Reimbursement * Professional Development/CEU’s * Life and Short- & Long-Term Disability insurance * Credit Union * Team Member Recognition Events * Referral bonus * CPR-employer paid * Travel mileage reimbursement at federal rate Are you looking for a position where you can make a lasting impact in the lives of children and their families? Are you ready to brighten the future of Amazing Children? We want to hear from you! The Children's Institute of Pittsburgh is an Equal Opportunity Employer. We serve a diverse population of children and families, and we want our workforce to reflect that same diversity. We want all interested individuals to feel welcome in applying for a career at our amazing place – we can't wait to meet you! The Children's Institute does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, religious creed, AIDS or HIV status, disability, ancestry, age, gender, sexual orientation, gender identity or expression, genetic information, marital status, union membership, or veteran/military status in employment.

Responsibilities

The Authorization Specialist interacts with payers and physician offices to secure necessary referrals and authorizations for outpatient services across all sites. This role involves investigating client insurance coverage to ensure payment and acting as the primary communication point for insurance benefit coverage details.