Mangrove Management Partners · 11 hours ago
Authorization Specialist
Greater Boston, MA
Full-time
Onsite
Entry Level
$25/hr - $30/hr
1+ years expMangrove Management Partners is seeking an Authorization Specialist responsible for financially securing scheduled surgical procedures by verifying insurance eligibility and coverage. The role involves monitoring surgical cases, collaborating with departments, and ensuring compliance with regulations while safeguarding patient confidentiality.
Health CareVenture Capital
Responsibilities
Monitoring upcoming surgical cases, procedures and imaging on the physician’s calendars
Responsible for identification and authorization of all codes that may be used throughout complex and variable patient treatments
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans
Collaborates with other departments to ensure documentation is received prior to services
Assists with medical necessity documentation to expedite approvals and ensure the appropriate follow-up
Obtains, distributes, and documents referral authorization numbers
Helps monitor cancellations, expirations, and changes to authorizations and referrals
Documents authorizations and progress of authorizations in the patient’s chart
Ensures all updates to documentation in client's file are completed in a timely manner
Assists with the resolution of authorization related denials and billing holds
Participates in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases
Ensures compliance with appropriate industry regulations and State and Federal regulations
Safeguard strict confidentiality of all health records, member information and meet HIPAA guidelines
Assists with medical record requests, front desk tasks, and patient collections as needed
Performs other duties as assigned
Qualification
Required
1+ years of surgical insurance verification experience required
Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources
Proficiency in establishing good working relationships with both internal and external vendors/customers, both in person and over the phone
Outstanding written and verbal communication skills, with close attention to detail
Demonstrated ability to analyze data and work independently within a fast-paced work environment
Proficiency in technology, in particular Microsoft Office Suite
Excellent organizational and prioritization skills
Preferred
Bachelor's degree preferred
Vascular experience preferred
Company
Mangrove Management Partners
Mangrove Management Partners focuses on safety, compliance, and best practices across the clinical care and business management.
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
unknownKey Investors
Wells Fargo Strategic Capital
2021-10-22Series B
Leadership Team
Mark Rowe
Co-Founder, CEO and Director
Recent News
2024-04-26
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