Our client is looking for several Remote Prior Authorization Specialists because of its amazing growth! 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. The ideal candidate has 2-4 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
- Use the insurance verification systems to contact the patient and their partner’s insurance to verify benefits, identify benefit maximums and coordinate benefits
- Identify any need for documentation to obtain treatment precertification and notify provider immediately
Prior Authorization Specialist Requirements:
- 2-4 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!
Associate Unit Manager, Healthcare Revenue Cycle
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