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About the Role
The Patient Engagement Authorization Specialist I (IAS II) is responsible for financially securing Ambulatory, Ancillary, Surgical and Procedural services. This includes securing Referral and Authorization, Insurance Verification and Benefit interpretation to ensure adherence to insurance guidelines. The role requires the ability to interact with patients and stakeholders for successful financial clearance and to comply with authorization and referral guidelines. Success in this position requires the ability to work in a high-volume, fast-paced environment, understanding complex patient scheduling needs with empathy and compassion, and utilizing eligibility application and authorization portals to verify insurance, interpret responses, and capture necessary health insurance information. The role also involves understanding and applying contractual benefits and collecting patient financial obligations pre-service.
Responsibilities
- Financially secure Ambulatory, Ancillary, Surgical and Procedural services.
- Secure Referral and Authorization.
- Perform Insurance Verification and Benefit interpretation.
- Ensure adherence to insurance guidelines.
- Interact with patients and stakeholders for financial clearance.
- Comply with authorization and referral guidelines.
- Utilize eligibility application and authorization portals.
- Verify insurance eligibility.
- Interpret insurance eligibility responses.
- Capture appropriate health insurance information.
- Understand and apply contractual benefits to services rendered.
- Collect patient financial obligations pre-services.
Requirements
- Possess a winning customer service personality with the ability to engage patients, providers, provider staff, and insurance company representatives via telephone.
- Demonstrate superior patient experience skills.
- 3-5 years of experience in a hospital, physician office, or call center environment is preferred.
- Strong insurance knowledge specific to complex scheduling needs and authorization management is required.
- Ability to manage the pressure of very tight timeframes to execute tasks.
- Ability to learn in a classroom setting, utilizing resources.
- Ability to remain composed under pressure.
- Ability to train and onboard colleagues.
- Ability to review information and draw appropriate conclusions.
- Good judgment and resourcefulness to problem-solve and escalate issues as needed.
- Team-minded work ethic.
- Demonstrated ability to interpret patient insurance benefits and apply applicable contractual obligations.
- Critical thinking ability regarding issues with financially securing payment.
- Must ensure information access is based on a “need to know” basis and is the minimum necessary to properly perform assigned duties.
- Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.
- Make reasonable efforts, consistent with Albany Med Health System policies and standards, to ensure information is adequately protected from unauthorized access and modification.
Skills
- Proven customer service skills with the ability to exceed expectations.
- Demonstrated knowledge of payer authorization requirements.
- Strong attention to detail.
- Ability to multi-task in a stressful and high patient volume unit.
- Ability to train and onboard colleagues.
- Ability to review information and draw appropriate conclusions.
- Good judgment.
- Resourcefulness to problem-solve.
- Ability to escalate issues as needed.
- Team-minded.
- Interpreting patient insurance benefits.
- Applying applicable contractual obligations.
- Critical thinking.
- HIPAA Protected Health Information knowledge.
- Understanding of Federal and New York State statutes regarding sensitive information.
Location
- Day (United States of America)
Work Type
- Full-time
Experience Level
- 3-5 years preferred
Education Level
- Associate Degree
- Bachelor Degree preferred
Salary/Compensations
- $49,763.00 - $69,668.00
- $18.00 - $28.76
About the Company
- Albany Med Health System is an equal opportunity employer.
- This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.
Equal Opportunity
- Albany Med Health System is an equal opportunity employer.