Our client is looking for several Prior Authorization Specialists because the amazing growth within its healthcare organization! The ideal prior experience would be working with physicians and clinical staff in a medical or clinical setting and a person who thrives in a fast-paced, production-oriented work environment is also preferred! The Prior Authorization Specialist will be responsible for processing insurance verification and referral/pre-certification/pre-authorization requests. An ideal candidate would have 3-5 years of prior authorization experience within the last 7 years.
Prior Authorization Specialist Responsibilities:
- Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization
- Extend expired authorizations when treatment has been delayed
- Uses the insurance verification systems to contact the patient and their partner’s insurance to verify benefits, identify benefit maximums, and coordination of benefits
- Identify any need for documentation to obtain treatment precertification and notify provider immediately
Prior Authorization Specialist Requirements:
- 3-5 years of prior authorization experience
- Understanding of insurance requirements for prior authorization.
- Knowledge of registration, verification, pre-certification, and scheduling procedures.
- Understanding of payer processes to submit appropriate clinical documentation.
- Strong proficiency computer navigation skills, with basic Microsoft Office/Outlook skills
- Medical Terminology Knowledge required
If you are qualified and interested in the Prior Authorization Specialist role, please apply today!
Senior Project Manager, Healthcare Revenue Cycle
Keywords and Related Terms: scheduling , referrals, insurance verification, pre-authorization, pre-certification, patient access , registration , registrar , insurance , review , submit , compliance , discrepancies ,
LaSalle Network is an Equal Opportunity Employer m/f/d/v.
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