Job Description:

POSITION SUMMARY

The Authorization Specialist is an integral member of the healthcare team and is responsible for

obtaining pre-certifications and pre-authorizations for procedures, durable medical equipment and

medications including any other authorizations as needed per clinic. Works with internal physician office

staff, patients, providers and clinical staff to facilitate a fast and efficient authorizations process.

Consistently facilitates effective communication between our patients, families, insurance companies,

providers and members of the patient care support staff and participates in quality performance

improvement activities to support a positive patient focused customer service experience.

POSITION QUALIFICATIONS

Education/Licensure/Certification:

· High School Diploma or GED required

Knowledge:

· A minimum of two years’ customer service experience preferred, preferably within a healthcare

environment preferred

· Experience working with patients and providers, using EPIC (electronic health record)

· At least one year of experience with insurance/medication authorizations preferred

Skills:

· Requires exceptional communication and customer service skills, strong organizational skills,

ability to prioritize and manage a great number of details and multi-task with strong follow

through are mandatory.

· Ability to take initiative, learn quickly and actively, participate as part of an administrative team

also required.

· Computer proficiency with MS Office Suite, including Word and excel, and Google applications, as

well as an ability to learn new programs with ease

· Must have the ability to establish and maintain effective working relationships with all levels of

staff, volunteers, and the general public.

· Must possess excellent interpersonal skills and be comfortable with people in all stages of health

and healing.

· Must adhere to HIPAA regulations and maintain clinic, provider, RN and patient confidentially

· Comfortable with regularly verifying and processing insurance eligibility and obtaining

authorization requests, including verifying personal credentials with external partners to obtain

this information (e.g., ID.me for identity verification for VA insurance coordination).

Authorization Specialist - MMF Orthopedics