Authorization Specialist - Remote

Overview

The Authorization Specialist at Lehigh Valley Health Network plays a crucial role in obtaining benefits and authorizations for various healthcare services, ensuring compliance with network policies and effective communication with insurance companies.

In Short

• Collaborates with physicians to determine necessary authorizations.
• Performs medical necessity checks for procedures and diagnoses.
• Communicates with insurance companies for verification and precertification.
• Maintains compliance with authorization benchmarks.
• Determines estimated patient financial responsibilities.
• Handles billing duties to ensure timely payments.
• Ensures authorizations align with network policy.
• Reviews work queues to confirm authorizations prior to patient visits.
• Requires specialized training in insurance and billing.
• Must be familiar with healthcare laws and patient rights.

Requirements

• High School Diploma/GED with specialized training in healthcare.
• 1 year of experience in a healthcare setting.
• Knowledge of billing procedures and payer reimbursement.
• Understanding of HIPAA and patient rights.
• Proficient in utilization management processes.
• Familiarity with standard medical practices.
• Ability to lift and carry 25 lbs.
• Frequent keyboard use required.
• Preferred: Associate’s Degree.

Benefits

• Opportunity to work in a recognized health network.
• Engagement in a culture of trust and collaboration.
• Access to career growth and development opportunities.
• Work in a supportive environment focused on patient care.
• Competitive compensation and benefits package.