An Authorization Specialist normally works with companies that handle insurance claims such as – automotive shops, private medical practice, and hospitals. The Authorization Specialist job role is to take insurance information from the clients and determine if any authorization is required for the service that is to be undertaken. The Authorization Specialist Resume enlists the following day-to-day tasks shouldered by these specialists – interviewing and assisting clients or patients with their authorization documents, ensuring payment for service, inputting insurance authorization and referrals prior to service, monitoring authorizations and making necessary payment arrangements.
The most sought-after qualifications for this role include – strong verbal and written communication skills, customer service skills, strong knowledge and understanding of what the company offers, proficiency with medical coding such as ICD 9 and CPT; data entry and strong typing skills. Employers want to see in the resume a degree in business or the related.
Summary : Highly qualified Authorization Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Microsoft Word And Excel.
Description :
Work closely with Site Manager and Nurse Case Manager with reviewing clinical data matching it against medical diagnosis or procedure codes for further review.
Accurately entering required information into eChamp computer data base.
Maintained patient confidentiality as defined by HIPPA, State, Federal and Company regulations.
Exceptional interpersonal, organizational skills covering 5 sites, example: Rockaway Pkwy, Bushwick, Allerton, Chrystie Street and Wallenstein.
Responsible for providing accurate and complete data input for pre-certification requests and excellent customer service.
Problem solving, detail oriented, strong analytical skills.
Built a lasting bond with the patient that assisted in there healing process and journey to recovery.
Experience
7-10 Years
Level
Management
Education
Business Management
Sr. Authorization Specialist Resume
Summary : To obtain a position within the medical field that is meaningful and challenging also that allows attention to detail, compassion and willingness to help be a beacon of peace to those who are in need.
Skills : Medical Records, Medical Terminology, Insurance Verification.
Description :
Ensure payment for services by verifying benefits with insurance provider.
Obtain, review and input insurance authorization and referrals prior to patient services.
Monitor and track patient authorizations, informing supervisor of any expired dates.
Interview and assist patients with authorization documents, as appropriate.
Maintain appropriate logs or reports according to professional, state, and federal requirements.
Responsible for the procurement of all documents relating to FMLA, Disability, Medical necessity review, Clinical certification and any special needs documentation.
Arranged appointment for specialist, hospice and other necessary out of office procedures.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Science
Insurance Authorization Specialist Resume
Objective : Vast experience in developing strategies; possesses good interpersonal skills and team interactions to work with a variety of professionals Experience in customer service with great clerical skills and administrative skills.
Skills : Computer Skills, Critical Thinking.
Description :
Increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.
Ensure payment for services by verifying benefits with insurance provider.
Obtain, review and input insurance authorization and referrals prior to patient services.
Monitor and track patient authorizations, informing supervisor of any expired dates.
Interview and assist patients with authorization documents, as appropriate.
Maintain appropriate logs or reports according to professional, state and federal requirements.
Proactively assesses customer issues and anticipates their needs.
Experience
2-5 Years
Level
Junior
Education
Surgical Technology
Preauthorization Specialist Resume
Objective : Attorney at law degree with a specialization in constitutional law and human rights. Excellent project management and time management abilities with broad experience in various business divisions and industries. Developed strong interpersonal and communication skills while working abroad. Ambitious and enthusiastic, ability to learn and adapt quickly and provide results under pressure. Experienced in project management and team leadership.
Skills : Microsoft Office, Leadership.
Description :
Completes the registration process for incoming patients in EPIC.
Verifies and updates necessary insurance information using EPIC and PASSPORT.
Obtains necessary referrals or authorizations required by the insurance company.
Checks charge logs for patients to ensure that authorization obtained and CPT code matches.
Assists in answering any questions co-workers may have in the EPIC system o Attends super user meetings to provide feedback and suggestions for our current work queues.
Assists co-workers in filtering work queues to make our workflow more efficient.
Responsible for getting authorizations by contacting doctors' offices for Medicare and Medicaid HMO, PPO, etc plans.
Experience
2-5 Years
Level
Executive
Education
Associates In Business
Sr. Authorization Specialist Resume
Summary : Customer-oriented professional successful at troubleshooting and handling customer support issues in a timely manner. Highly organized and meticulous with experience in corporate office settings.
Effectively managed a high-volume of inbound and outbound customer calls.
Addressed and resolved customer product complaints empathetically and professionally.
Gathered and verified all required customer information for tracking purposes.
Defused volatile customer situations calmly and courteously.
Accurately documented, researched and resolved customer service issues.
Mastery of customer service management systems and databases.
Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.
Managed high call volume with tact and professionalism.
Experience
10+ Years
Level
Senior
Education
Finance
Jr. Authorization Specialist Resume
Objective : Working closely alongside law enforcement, insuring a safe environment for event goers and bystanders alike. Worked and succeeded in several world renowned companys.
Work hand-in-hand with service providers nationwide to ensure that homeowners were properly taken care of.
Troubleshoot with technicians to diagnose problems and properly advise on how to repair.
Making final decisions on money being spent by the company.
Work directly with homeowners to ensure utmost satisfaction and continued loyalty to the company.
Promoted within the first month of working.
Claim organization Time micromanagement Ability to handle high call volume, high stress and very upset homeowners and technicians with a positive attitude and a helpful insight.
Experience
2-5 Years
Level
Junior
Education
Bachelor Of Science
Authorization Specialist III Resume
Objective : As a dedicated and knowledgeable professional with experience in administrative support and healthcare assistance, I seek to bring my abilities to increase the effectiveness of your organization.
Skills : Microsoft Office.
Description :
Obtained proper authorizations from insurance companies in a timely manner and kept them up to date.
Verification of insurance eligibility and benefits.
Obtaining proper documentation in order to continue billing insurances.
Verified daily billing submission report for insurances, including HCPCS codes, ICD-9 codes and modifiers.
Appealed denied claims to the insurance in order to obtain lost revenue.
Reviewed lost revenue report in order to fix invoices to be released.
Verified the aging report in order to check for a valid authorization and to check which claims needed to be appealed.
Experience
2-5 Years
Level
Junior
Education
Information Technology
Authorization Specialist II Resume
Objective : Currently looking for a full time position in an environment that offers a greater challenge, increased benefits for me and my family, and the opportunity to help the company advance efficiently and productively.
Skills : Extensive Customer Service And Computer Skills.
Description :
Update patient information, work closely with Physicians and Insurance to ensure special needs children receive authorization of medical supplies.
Speak to families each month regarding supplies that are needed or any changes in supply needs.
Employee of the month Gold Star Employee Skills Used Customer Service Durable Medical Equipment Maintain client charts.
Update patient information, work closely with Physicians and Insurance to ensure special needs children receive authorization of medical supplies.
Speak to families each month regarding supplies that are needed or any changes in supply needs.
Proceeded to work the authorizations off of the clinical received from the referring doctor.
Verify benefits for the exam the patient is having done, obtain the authorization and send it to the girls and schedule.
Experience
2-5 Years
Level
Executive
Education
Medical Assistant
Authorization Specialist I Resume
Objective : To establish a long-term career in a company where I may utilize my Authorization Specialist I professional skills and knowledge to be an effective Associate Program Manager and inspiration to those around me.
Skills : Bilingual: English,Spanish, proficient in all microsoft office applications, ICD-9 and CPT Coding, ability to multi-task and perform under pressure, familiarilty with medical terminology and anatomy and physiology.
Description :
Entering patient demographics and notes in the Medical Mastermind database.
Checking patient eligibility and benefits with their insurance company.
Calculating patient responsibility for tests to be performed or equipment to be received.
Posting patient payments to their account in the Medical Mastermind database.
Speaking with patients to make payment on their account.
Training new employees on the authorization process.
Create training documents to assist new employees to better understand the authorization process.
Experience
2-5 Years
Level
Executive
Education
BS
Authorization Specialist Resume
Objective : Responsible for Updating all clinical diagnosis and medication given by Social Workers, Case Managers, Licensed Registered Nurses or Home Health Aides, into database for each member as required via interim orders.
Skills : Computer Skills: Word, Customer Service Skills.
Description :
Maintains consistent follow-up for the status of a submitted authorization request.
Initiate registration process for patient assistance programs.
Verify non- Medicare coverage, tracked, maintained and updated visit statuses.
Verified insurance policy benefits for new and returning patients with carriers and employers.
Educated patients and families on insurance issues.
Notified appropriate work units of patients insurance coverage, authorizations or status.
Assists in the coordination of quality management activities with all affiliates.
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