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Touro College Authorization Specialist in Henderson, Nevada

The Authorization Specialist will be responsible for performing insurance verification, including benefits and authorizations for the TUN Center for Autism and Developmental Disabilities. The Authorization Specialist will have heavy phone contact with the insurance companies, communicate with insurance companies’ authorization department regarding any CPT/DX code discrepancies, and contact patient prior to appointment if there are any insurance/authorization issues. The Specialist must have good organizational skills with attention to detail, excellent customer service technique, and serve as a valuable resource to patients as an advocate.

  • Ensure complete and accurate registration, including patient demographic and current insurance information

  • Obtain authorization per payer requirements for services rendered and ensures authorization information is documented appropriately in Allscripts.

  • Verify patient insurance benefits for all assigned patients within program required time-frames.

  • Communication is maintained with patients, payers, and therapists regarding status and financial responsibility.

  • Maintain a daily report that tracks the activity of all open authorizations.

  • Ensure that authorizations are addressed in a timely manner.

  • Follow Federal and State Insurance guidelines

  • Maintain the strictest confidentiality in accordance with HIPAA regulations and Center requirements.

  • Other duties to be assigned as necessary.

Education:

  • High School diploma or equivalent required

  • Medical Assistant Certification or Medical Billing Certificate preferred

Experience:

  • Minimum of 3 years’ experience working with the authorization process and how it coincides with the insurance companies.

  • Experience with ICD-10 and CPT Codes

  • Working knowledge of Medicaid, HPN/SHL, and commercial insurance carriers billing regulation.

  • Knowledge of patient registration, scheduling, authorizations, billing and medical policies.

  • Ability to effectively handle multiple responsibilities simultaneously in a deadline driven environment.

  • Strong understanding of benefits investigating ; deductibles, co-insurance, out-of-pocket expense and benefit exclusions

  • Excellent organizational skills with attention to detail and follow-up

  • Excellent telephone etiquette

  • Knowledge of Electronic Health Record and Practice Management Systems

  • Knowledge of HIPAA guidelines including PHI privacy requirements

Skills & Abilities:

  • Strong Customer Service focus

  • Effective verbal and written communication skills

  • Teamwork orientation

  • Organized and able to manage priorities

  • Good judgment

  • Resourcefulness in problem-solving

  • Able to take and follow through with delegated tasks and accountability

  • Demonstrated experience insurance requirements for referrals and prior authorizations to various therapies, procedures, diagnostic testing, specialist, etc.

Requisition ID: 2020-6881

Schedule Shift: Day

Hours Per Week: 40

Travel: None

External Company URL: https://tun.touro.edu/

Street: 874 American Pacific Drive

Chart of Accounts: Touro University Nevada

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