Prior Authorization Coordinator

iSpine Clinics is a growing pain management practice that provides compassionate, personalized, and coordinated care to patients. Our mission is to improve our patients’ quality of life by providing minimally invasive and maximally effective treatments for chronic pain conditions.

We are excited to be offering a full-time (40 hrs/week) Prior Authorization Coordinator position. This position is scheduled Monday - Friday rotating: 8:00 am to 4:30 pm There will be no weekends or holidays.

General summary of duties: The Prior Authorization Coordinator is responsible for obtaining prior authorizations and referrals from insurance companies and other 3rd parties for procedures, office visits, therapy, and imaging services.

Position reports to: Prior Authorization Lead

Job qualifications:

• Minimum of 1 year of insurance, prior authorization or referral experience in healthcare or pharmacy office environment preferred
• Knowledge of medical business office and revenue cycle procedures and skills in identifying and resolving problems
• Ability to establish and maintain effective working relationships with patients, staff and community
• Ability to read, write and communicate effectively orally and in writing
• Proficiency in the operation of a computer and other office equipment
• Sit for extended periods of time; push, pull and reach; occasionally bend, stoop and stretch
• Maintain a current and valid driver’s license as position may require occasional driving to other locations

Duties and responsibilities:

• Understanding of and adherence to each payer prior authorization policies and procedures
• Contact review organizations and insurance companies to ensure prior approval requirements are met
• Ensure that orders and referrals are reviewed and/or submitted within 48 hours of receipt
• Communicate with providers regarding any incomplete patient notes and/or incomplete orders
• Keep patients updated with status of prior authorization and/or referrals
• Enter and scan authorizations and denials into the patients EHR
• Work with providers and/or leadership to determine next steps if procedure is denied and submit appeals as needed
• Accept incoming calls from patients, insurance carriers and other 3rd parties
• Work closely with billing team to assist in claim reimbursement
• Keep lead/manager apprised of any internal/external issues and concerns preventing and/or disrupting daily workflow
• Serve as back up to Prior Authorization Referral Coordinator
• Other duties as assigned

Work environment:

The work of this position is performed in an environmentally controlled office environment. The position requires the ability to work under pressure and with a diverse population, including staff, physicians, clients, patients, insurance companies and other members of the public.

Job Type: Full-time

Pay: From $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person