Authorization Specialist
Pain Specialist of OC
- Assisted in processing authorization requests for various healthcare services.
- Maintained accurate documentation of patient information and authorization outcomes.
- Learned to navigate electronic health record systems to streamline authorization workflows.
- Collaborated with healthcare providers to clarify patient eligibility and benefits coverage.
- Gained proficiency in regulatory compliance and best practices for authorization processes.
- Adapted quickly to evolving policies and procedures to enhance workflow efficiency.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Developed strong relationships with insurance representatives to expedite approvals and resolve issues promptly.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations in a professional manner.
- Resolved discrepancies with client applications to verify eligibility.
- Trained staff on current eligibility requirements and policies.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Contacted clients about verifying account information and updated services, answered questions and resolved concerns to uphold exceptional customer service standards and promote brand loyalty.
- Referred delinquent accounts to collections department or outside resources.
