Workplace Type: Onsite/Hybrid
Employment Type: FT
Job Location: Barberton, OH
JOB SUMMARY
The Authorization Specialist is a pivotal role within CHM, solely responsible for the detailed authorization of medical bills. This role ensures accurate processing of medical bills in alignment with CHM Guidelines while also supporting Medical Review Specialists through complex and challenging cases. Authorization Specialists are highly detailed with a focus and attention in maintaining accuracy of medical bills.
ROLES & RESPONSIBILITIES
- Verify eligibility and authorize medical needs/incidents in accordance with CHM’s Guidelines, ensuring accuracy and completeness.
- Input and update member information with an error rate of less than 1%.
- Perform thorough checks on memberships to identify key eligibility factors.
- Collaborate with other departments to rectify discrepancies in member information.
- Respond to correspondence from members or staff within a 24–48-hour timeframe.
- Maintain an approachable and appropriate attitude when interacting with CHM members and staff.
- Support vision and culture of the organization and Executive Leadership.
- Participate in on-going education and training as assigned by the Eligibility Adjudication Supervisor.
QUALIFICATIONS & REQUIREMENTS
- Task-Oriented: Must be highly motivated and task-focused.
- Self-Starter: Holds self and team accountable for getting things done both accurately and efficiently.
- Servant Leader: Willing to step in to do whatever is needed.
- Communication Skills: Excellent communication skills, both written and verbal.
- Technical Skills: Experience with Excel, Word, PowerPoint, and Outlook.
- Organizational Skills: Great organizational skills.
- Responsiveness: Responsive to the needs of the team and ministry.
- Teachability: Teachable and approachable.
- Values Alignment: Models CHM’s core values and mission statement.
- Handbook Knowledge: Expert knowledge of the CHM Guidelines and employee handbook.
- Team Player: Works well within a team environment.
- Positive Attitude: Maintains a positive attitude.
- Professional Appearance: Upholds a professional appearance.
EDUCATIONAL REQUIREMENTS
- High school diploma or equivalent.
- Basic knowledge of medical terminology and healthcare practices is preferred.
- Willingness to learn medical-related concepts through on-the-job training is required.
ADDITIONAL NOTES
- Model CHM’s Core Values, Mission Statement, and Vision Statement.
- Work as a team player with all departments and assist them when needed.