Authorizations Specialist

At GenesisCare we want to hear from people who are as passionate as we are about innovation and working together to drive better life outcomes for patients around the world.

Insurance Authorizations Specialist

Role Summary:

This role ensures timely authorizations and referrals are obtained, and primary and/or secondary insurance information is verified and correct on the patient account in the Intergy system. This role also plays an important role in supporting patient benefit eligibility and patient financial estimates.

Your Key Responsibilities:

• Obtaining required referrals and authorizations prior to services via phone, fax, online etc.
• Review Office Schedules daily for patients requiring authorizations, referrals and insurance verification.
• Obtaining retro authorizations in a timely manner.
• Scanning authorization requests, approvals etc into imagining in Intergy.
• Informing the Clinical Appeals unit, front desk, financial counselor and department manager when a treatment or service is denied.
• Coordinating any insurance verification needs from the patient with the office.
• Updating the patient account with details of the insurance verification in the CIVU questionnaire.
• Coordinating with the front desk staff on the proper insurance plan to be entered on the account as needed.
• Communicating with Office Staff when there is a pre-existing condition affecting coverage.
• Follow up with front desk or financial counselor when documents are required to assist with insurance verification/authorization process.
• Contact the physicians, front desk, financial counselor, Regional Director, Executive Director of Revenue Cycle and Manager when a Peer to Peer is requested.
• Follow up daily with the insurance until you receive a valid authorization.
• Attending insurance meetings/online website trainings for payer specific updates and information as required.
• Assisting with department process manual updates as payer requirement changes are noted.
• Keep up to date on authorization / referral requirements from the insurance plans.
• Verifying Medicare for SNF dates. Informing the financial counselor and billers when appropriate.
• Verifying all Self Pay patients for Medicaid monthly. Notify the financial counselor and billers.
• Re-verify all patients monthly for active, current insurance.
• Re-verify all active patients in treatments for required authorization or referral.
• Participating with process improvement as needed.
• Researching account insurance questions to find the correct answer.
• Assisting verification or collection staff with account questions when presented.
• Maintain current on insurance verification processes, changes and being aware of the most recent requirements.
• Responsible for obtaining and maintaining the required productivity by the assigned insurance.
• Other duties as assigned.

Minimum Qualifications:

• High school graduate or equivalent.
• 1-3 years of Health care work experience, preferably in with insurance verification/authorizations
• Knowledge of medical terminology as well as ICD-9 and CPT codes.
• Strong understanding of healthcare plan terminology and benefits.

Preferred Qualifications:

• Experience with Medical Manager or other practice management system preferred

About GenesisCare:

An integrated oncology network in Florida and North Carolina providing care for more than 115,000 patients annually, GenesisCare offers community-based cancer care at convenient, freestanding locations. The company’s purpose is to redefine the care experience by improving patient outcomes, access, and care delivery. With advanced technology and innovative treatment options, our skilled physicians and support staff offer comprehensive and coordinated care in radiation oncology, medical oncology, hematology, urology, diagnostics, ENT and surgical oncology. For more information, visit genesiscare.com/us.

GenesisCare is an Equal Opportunity Employer that is committed to diversity and inclusion.

GenesisCare is an Equal Opportunity Employer.