Insurance specialist vs authorization specialist

Differences between insurance specialist and authorization specialist duties and responsibilities

Insurance specialist example responsibilities.

• Manage database by processing renewals and endorsements.
• Maintain confidentiality and adhere HIPPA guidelines with handling patients' information
• Make recommendations on operationalization and oversight of specific marketplace enrollment policies.
• Verify various health insurance plan benefit information and eligibility for patients with chronic illnesses.
• Identify third party patient eligibility for Medicaid, Medicare, private insurance and alternate resources.
• Enter and prepare advanced beneficiary notices base on diagnosis and procedure codes for Medicare cover patients.
Show more

Authorization specialist example responsibilities.

• Demonstrate knowledge of HIPAA by appropriately managing patient confidentiality.
• Utilize CMS and InterQual criteria to establish authorizations for members requiring medical services for a Medicare advantage insurance company.
• Build authorization, match ICD-10 codes with there procedure codes
• Provide patients with patient registration forms in order to follow up on patient check-in and check-out utilizing a proprietary management system.
• Obtain verification of insurance coverage and authorizations for clinical visits and surgical procedures for patients.
• Perform all components of the office registration including arrival, check-in and future appointments.
Show more