Medical Authorization Specialist

About Alpha Nodus: At Alpha Nodus, we are at the forefront of technological innovation and committed to delivering cutting-edge solutions to our global clientele. Our team thrives on creativity, collaboration, and a passion for challenging the status quo.

Job Description: We are seeking a dedicated and detail-oriented Authorization Specialist to join our team. The ideal candidate will work night shifts to support our US-based healthcare centers. You will be responsible for obtaining medical authorizations for diagnostic imaging procedures, verifying insurance details, providing customer support, and ensuring compliance with healthcare regulations.

Key Responsibilities:

• Obtain Medical Authorizations: Secure authorizations for diagnostic imaging procedures by interacting with payer websites, electronic medical records (EMRs), and verifying required documents.

• Customer Support:

• Deliver timely and efficient solutions while ensuring clear communication with customers.

• Provide comprehensive support to address customer-reported issues by effectively triaging and reproducing the problems.

• Additionally, create detailed support documentation to guide users through troubleshooting steps and solutions, helping to prevent future occurrences and improving the overall customer experience.

• Medical Record Review: Review physician orders, including CPT and ICD-10 codes, to ensure the accuracy of diagnoses and medical authorizations.

• Confidentiality and Compliance: Ensure patient privacy is maintained in alignment with HIPAA and company guidelines.

• Cost Estimation: Generate cost estimates for medical procedures.

• Denial Processing: Process authorization denials by re-appealing them or resubmitting the request with correct information.

• Review and validate the accuracy of product outputs, ensuring eligibility and prior authorization correctness.

• Perform other duties as assigned to support the team and operational efficiency.

Requirements:

• Experience: 3+ years.
• Education: High school diploma or equivalent.
• Demonstrated willingness to learn and adapt to new challenges in a dynamic environment.
• Strong written and verbal communication skills for effective interaction with both internal teams and external stakeholders.
• An innovative thinker with a creative problem-solving approach and the ability to quickly adapt and respond to challenges.
• A fast learner who thrives in a high-paced, evolving environment.
• A collaborative team player with a strong work ethic and a positive attitude.
• Exceptional attention to detail, ensuring accuracy and precision in all tasks.