Authorization Specialist
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Job Description
Remote authorization specialist securing payer approvals for Option Care Health’s home infusion services. Verifying medical necessity, insurance eligibility, and clinical documentation.
Responsibilities:
- Submit accurate and timely authorization requests to insurance companies and payers.
- Ensure proper setup and maintenance of patient accounts in the system.
- Obtain and review clinical documentation to verify medical necessity.
- Communicate with healthcare providers to gather required authorization information.
- Verify insurance benefits and eligibility for services.
- Monitor authorization request status and follow up as needed.
- Ensure compliance with payer requirements and regulations.
- Utilize basic medical coding, diagnosis codes, and medical terminology in the authorization process.
- Maintain detailed records and documentation for all authorizations.
- Collaborate with billing and claims teams to resolve authorization-related issues.
Requirements:
- High school diploma or equivalent is required.
- Ability to multi-task and support numerous referrals/priorities at one time.
- Ability to work in a fast past environment.
- High degree of self-discipline in maintaining productivity expectations.
- Must be detail-oriented and have a high degree of quality focus.
- Basic medical coding, diagnosis codes, and medical terminology knowledge.
- Healthcare/medical billing experience preferred.
- Must reside in PST/MST.
Benefits:
- Medical, Dental, & Vision Insurance
- Paid Time off
- Bonding Time Off
- 401K Retirement Savings Plan with Company Match
- HSA Company Match
- Flexible Spending Accounts
- Tuition Reimbursement
- myFlexPay
- Family Support
- Mental Health Services
- Company Paid Life Insurance
- Award/Recognition Programs
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