Job Description

Overview

Job Summary
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our team. In this role, you will be responsible for managing the prior authorization process for medical procedures and services, ensuring compliance with insurance requirements while facilitating timely patient care. The ideal candidate will have a strong understanding of medical terminology, coding, and insurance verification processes.

Responsibilities

• Review and process prior authorization requests for medical services and procedures.
• Communicate with healthcare providers, patients, and insurance companies to gather necessary information.
• Verify patient eligibility and benefits.
• Utilize medical coding knowledge (ICD-10) to accurately document procedures and diagnoses.
• Ensure compliance with HIPAA regulations while handling sensitive patient information.
• Maintain accurate records of all authorization requests and follow up on pending authorizations.
• Collaborate with dental and medical offices to streamline the authorization process.
• Provide support in resolving any issues related to denied authorizations or appeals.

Experience

• Previous experience in a medical office setting is preferred.
• Proficiency in medical terminology and coding practices is essential.
• Familiarity with managed care processes and insurance verification is highly desirable.
• Strong organizational skills with attention to detail to manage multiple requests efficiently.
• Excellent communication skills, both verbal and written, to effectively interact with various stakeholders.

Join our team as a Prior Authorization Specialist where your expertise will contribute significantly to our commitment to providing exceptional patient care.

Job Type: Full-time

Benefits:

• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• 401K
• Aflac 

Work Location: In person

Join us in making a difference in our patients' lives by providing exceptional care coordination!

People with a criminal record are encouraged to apply

 

This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s).  Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.  

No Third Party Agencies or Submissions Will Be Accepted.  

Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP  

Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.

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