MLee Healthcare Staffing and Recruiting, Inc
Access Authorization Specialist
MLee Healthcare Staffing and Recruiting, Inc, Great Bend, Kansas, United States, 67530
Join a compassionate team dedicated to ensuring smooth patient access and insurance verification in a supportive healthcare environment located in the Central Plains region of the United States. This role focuses on identifying insurance coverage, obtaining necessary pre-certifications, and assisting with referral data entry to promote positive outcomes for patients and the agency.
Key Responsibilities
Verify insurance eligibility and benefits accurately. Obtain pre-certifications and ongoing authorizations from various insurance providers. Support intake and referral processes to ensure timely patient care and optimal staffing. Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines. Participate in audits and data submissions required by insurance and regulatory bodies. Ensure compliance with certification, PPOC, and Face-to-Face requirements. Conduct audits of admissions and patient records for quality reporting and program-specific conditions. Complete pre-billing and performance improvement chart audits as assigned. Maintain clear and timely documentation in accordance with agency policies. Foster effective communication and cooperation with physicians, staff, and clients to support reimbursement processes. Perform clerical duties such as managing phone calls and processing incoming faxes. Adhere strictly to HIPAA regulations regarding Protected Health Information (PHI). Education
High School Diploma required. Associate's or Bachelor's Degree in Health Care or Business preferred. Experience
Medical office experience and knowledge of medical terminology preferred. Experience with insurance authorization processes is a plus. Skills and Requirements
Advanced computer skills, including proficiency with medical record systems and Microsoft Office. Strong communication abilities and keyboarding skills. Valid driver's license and proof of auto liability insurance as required by state regulations. Demonstrated integrity, compassion, accountability, respect, and excellence in customer service. Ability to work independently and adapt to changing priorities.
This position offers a competitive salary and a generous benefits package, providing a meaningful opportunity to contribute to patient care in a regional healthcare setting.
Key Responsibilities
Verify insurance eligibility and benefits accurately. Obtain pre-certifications and ongoing authorizations from various insurance providers. Support intake and referral processes to ensure timely patient care and optimal staffing. Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines. Participate in audits and data submissions required by insurance and regulatory bodies. Ensure compliance with certification, PPOC, and Face-to-Face requirements. Conduct audits of admissions and patient records for quality reporting and program-specific conditions. Complete pre-billing and performance improvement chart audits as assigned. Maintain clear and timely documentation in accordance with agency policies. Foster effective communication and cooperation with physicians, staff, and clients to support reimbursement processes. Perform clerical duties such as managing phone calls and processing incoming faxes. Adhere strictly to HIPAA regulations regarding Protected Health Information (PHI). Education
High School Diploma required. Associate's or Bachelor's Degree in Health Care or Business preferred. Experience
Medical office experience and knowledge of medical terminology preferred. Experience with insurance authorization processes is a plus. Skills and Requirements
Advanced computer skills, including proficiency with medical record systems and Microsoft Office. Strong communication abilities and keyboarding skills. Valid driver's license and proof of auto liability insurance as required by state regulations. Demonstrated integrity, compassion, accountability, respect, and excellence in customer service. Ability to work independently and adapt to changing priorities.
This position offers a competitive salary and a generous benefits package, providing a meaningful opportunity to contribute to patient care in a regional healthcare setting.