Employment Opportunities

Authorization Specialist

This position is currently open.
Public?: 
Public
Division: 
Health
Reports To: 
Financial Director
Type of Position: 
Regular Full Time
Location: 
Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026

General Description
Responsible for completion of prior authorizations, pre-certifications, and notifications for all clinic in-house medical, specialties, pharmaceutical and diagnostic services. Utilizes a thorough working knowledge of insurance plans and benefit structures to obtain detailed benefit information and maximize benefits. Responsible for documenting/providing notifications of delays or denials of pre-authorizations/pre-certification approvals.

Responsibilities
  • Determine necessity for pre-authorization
  • Work with insurance to pre-certify/authorize the exam.
  • Ensures up-to-date documentation on patient’s accounts in Electronic Medical System on authorization approvals and denials. (Including approval dates, prior authorization number in patient profile.)
  • Review accuracy and completeness of information requests and ensure that they are properly and closely monitored.
  • Submit clinical supporting documentation to Insurance carriers to expedite prior authorization processes.
  • Manage correspondence with insurance companies, physicians and patients as required.
  • Look through denials and submit appeals to get them approved from insurances.
  • Proactively work on prior authorizations that are due to be expired.
  • Secure patients’ demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPPA compliance and regulations.
  • Ability to work independently with minimal supervision.
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
  • Performs other duties as assigned.

Education Requirements and Qualifications
Required Qualifications:
  • Education: High School Diploma / Some College Preferred
  • Certified Medical Assistant
  • 1-3 years of previous pre authorization experience
  • Knowledge of CPT, HCPCS, ICD-10 codes
  • Ability to produce detailed work accurately and efficiently
  • Ability to work with sensitive and confidential information
  • Strong organizational skills
  • Customer Service experience
  • Basic computer skills
Preferred Qualifications:
  • Previous experience working with a Native American entity.
Native American Preference/EEO/Drug Free/Smoke Free Workplace
Posted Date: 
4 years 11 months ago
Closing Date: 
Tuesday, May 28, 2019


Tribal Preference/Native American Preference/EEO/Smoke Free/Drug Free Workplace
Indian preference applies to all positions, but all resumes will be accepted.

Apply for This Job
Forward Completed Absentee Shawnee Tribe applications with resume to:
Absentee Shawnee Tribe
Human Resources Department
2025 South Gordon Cooper Dr.
Shawnee, OK 74801
Fax: 405-273-2710
Email: HR@astribe.com
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