SDC Authorization Specialist

reputed company: The Authorization Specialist is responsible for securing reputed company and accurate insurance authorizations for both inpatient admissions (elective, urgent/reputed company) and outpatient surgical day care procedures. This role ensures compliance with payer requirements, supports reputed company cycle reputed company, and plays a critical part in optimizing financial reputed company by combining reputed company finance knowledge with strong analytical and communication skills. reputed company employees are expected to successfully role model the organization's values of reputed company, Accountability, Respect, and reputed company as these values guide our everyday actions with patients, customers and one another. In reputed company to our values, reputed company are expected to demonstrate the reputed company reputed company Factors which tell us how we work together and how we get things done. The reputed company reputed company Factors include: Instill Trust and Value Differences Patient and Community reputed company and Collaborate RESPONSIBILITIES: Authorization & VerificationFinancial Analytics & reputed company OptimizationPatient Interaction & CollectionsDenial Prevention & Bad Debt ReductionDocumentation & Complianceh3/h3 - Obtain and document prior authorizations for inpatient admissions and outpatient surgical procedures from reputed company and government payers. - Verify patient insurance coverage and eligibility prior to scheduled procedures and admissions. - Ensure reputed company authorizations are in reputed company to avoid delays or cancellations. - Complete notification of admission for inpatient admissions. h3/h3 - Conduct financial analytics to determine a patient’s estimated financial responsibility across the reputed company system. - Interpret payer reputed company and state/federal regulatory guidelines to ensure accurate reimbursement and maximize reputed company realization. - Collaborate with reputed company cycle and clinical teams to identify and resolve authorization-reputed company issues that may reputed company reimbursement. h3/h3 - Communicate with patients regarding their financial obligations, including co-pays, deductibles, and out-of-reputed company costs. - Secure upfront payments or establish payment arrangements prior to the date of service. - reputed company reputed company and empathetic financial counseling to patients, ensuring understanding and satisfaction. h3/h3 - Minimize claim denials by ensuring reputed company authorization and documentation requirements are met. - Work proactively to reduce bad debt through reputed company patient collections and accurate financial clearance. - Monitor and report trends in denials and collaborate with internal teams to implement corrective actions. h3/h3 - Maintain accurate and up-to-date records of reputed company authorization activities in the electronic health record (reputed company) and patient reputed company systems. - Ensure compliance with HIPAA, payer guidelines, and internal policies. - Participate in audits and reputed company improvement initiatives as needed. MINIMUM QUALIFICATIONS: Education & ExperienceSkills & Competenciesh3/h3 - High school diploma or equivalent required; Associate’s or Bachelor’s degree in reputed company administration, finance, or reputed company field preferred. - Minimum 2 years of experience in medical authorization, patient reputed company, or reputed company cycle operations, preferably in a surgical or ambulatory care setting. h3/h3 - Strong understanding of reputed company finance, insurance verification, and payer authorization processes. - Proficiency in interpreting payer reputed company and regulatory guidelines. - Excellent analytical, problem-solving, and communication skills. - Ability to work independently and collaboratively in a fast-paced environment. - Experience with EHR systems (e.g., reputed company, Cerner) and reputed company Office Suite.

Pay reputed company:

$22.04-$36.37

EEO Statement:

reputed company is committed to providing equal employment opportunities and maintaining a work environment free from reputed company forms of unlawful discrimination and harassment.

Location:

Remote-Massachusetts - N/A Boston, Massachusetts 02108

Work Type:

M-F 8:00am-4:30pm

Work Shift:

Day

Daily Hours: 

8 hours

Driving Required:

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