Authorization Auditor – Healthcare/Medical Insurance
Company: ATI Physical Therapy
Type: Full Time
ATI Physical Therapy seeks an Auditor to join their team. As an Authorization Auditor, you are responsible for activities associated with auditing on-shore and off-shore Central Authorization Team (CAT) employees. If you have healthcare billing or accounts receivable (A/R) experience or worked in healthcare insurance authorizations, payor websites, clearinghouse applications, EMR, ICD-10 and CPT coding or have auditing experience, this may be a position for you.
- Complete research through interviewing payor representatives, researching procedures on payor websites, and testing procedures to ensure most efficient process is outlined in the SOPs.
- Demonstrate a strong knowledge of authorizations including Workers Compensation, Auto, Personal Injury, Medicare, Medicaid, and local HMO/PPOs.
- Handle a large volume of communication inbound/outbound calls and written correspondence within department standards for account resolution.
- Take appropriate action to resolve patient accounts including telephone, email, written correspondence, websites, and clearinghouse tools.
- Evaluate if escalations are due to vendor/onshore teams’ deviations from SOPs or if payor behavior has changes and communicate the remedial actions that are needed.
- Meet and maintain monthly productivity standards of quality and quantity.
- Collaborate with department leadership to review and root-cause authorization denials.
- Participate in action plans to resolve root causes.
- Communicate in a manner that results in positive relationships between ATI and customer.
- Provide exemplary customer service to internal and external customers.