Medical Authorization Specialist

2 days ago


Birmingham, Birmingham, United Kingdom Entalabama Full time
Job Title: Medical Authorization Specialist

Entalabama is seeking a highly skilled Medical Authorization Specialist to join our team. As a Medical Authorization Specialist, you will be responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers.

Key Responsibilities:
  • Review Chart Documentation: Ensure patient meets medical policy guidelines
  • Prioritize Authorization Requests: Prioritize incoming authorization requests according to urgency
  • Obtain Authorization: Obtain authorization via payer website or by phone and follow up regularly on pending cases
  • Maintain Payer Files: Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
  • Respond to Clinic Questions: Respond to clinic questions regarding payer medical policy guidelines
  • Confirm CPT and ICD-10 Diagnoses: Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
  • Contact Patients: Contact patients to discuss authorization status
  • Other Duties: Other duties as assigned
Our Full-Time Employee Benefits Include:
  • Paid Time Off (PTO): Paid time off (PTO)
  • Holiday PTO: Holiday PTO
  • 401(k) Plan: 401(k) plan
  • Profit Sharing Plan: Profit sharing plan


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