Job Posting
Authorization Specialist - Business Office
JOB DESCRIPTION
Business Office Department
Authorization Specialist
Job Summary: The Authorization Specialist is responsible for obtaining, verifying, and documenting prior authorizations required for services, procedures, medications, or transactions. This role ensures timely approvals, reduces delays, and supports efficient workflow by coordinating with providers, insurance carriers, clients, and internal teams. The ideal candidate is detail-oriented, organized, and skilled in communication and problem-solving.
Essential Responsibilities of the Position:
· Verify insurance coverage, eligibility, and benefits for services or procedures.
· Obtain and track prior authorizations from insurance companies or third-party payers.
· Communicate authorization status and requirements to relevant stakeholders (patients, providers, internal teams).
· Review and prepare necessary documentation for authorization requests.
· Ensure compliance with payer guidelines, regulations, and organizational policies.
· Maintain accurate and detailed authorization records in internal systems or electronic health records (EHR).
· Follow up on pending authorizations to prevent service delays or denials.
· Resolve authorization issues by contacting payers or researching guidelines.
· Collaborate with billing or revenue cycle teams to prevent claim denials.
· Escalate complex cases and document outcomes as needed.
· All other duties as assigned.
Professional Requirements:
· Adheres to Employee Standards of Behavior.
· Attends at least 75% of staff meetings; read, sign, and return all monthly staff meeting
minutes if absent.
· Strictly maintains patient confidentiality and abides by all HIPAA Privacy and HIPAA
Security rules.
· Communicates the mission, vision, and values of the Hospital as well as the focus statement of the department.
· Actively participates in the departmental and hospital-wide goals.
· Maintains a good working relationship both within the department and with other departments.
· Documentation meets current standards and policies.
· Treats patients and their families with respect and dignity.
· Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
· Demonstrates an ability to be flexible, organized and function under stressful situations.
· Observes infection control practices at all times.
· Participates in staff training and education programs.
Position Requirements:
· High school diploma or equivalent required
· Experience in an authorization, billing, insurance, or administrative support role (healthcare preferred if applicable).
· Knowledge of insurance terminology, coverage rules, and authorization processes.
· Strong communication skills, both verbal and written.
· Excellent attention to detail and organizational abilities.
· Proficiency with computer systems, EHR platforms, and authorization portals.
· Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
Physical Requirements:
· Job requirements include but are not limited to: sedentary work that primarily involves sitting, standing, walking, kneeling, bending, squatting, reaching and lifting objects up to 25 pounds. Requires good finger dexterity, repetitive motions with hands and fingers. Requires ability to have good vision and hearing. Pushing and pulling equipment may be necessary.
· Job requires medium lifting on an occasional basis.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.
Additional Information
Position Type : Full Time
Shift : Day
Contact Information
Christina Uribe - Human Resources Director
Human Resources
Email: curibe@dimmitregional.com |
