Prior Authorization Specialist

Duties and Responsibilities:

· Receive requests for prior authorizations via email, phone, or fax and ensure that they are properly and closely monitored.

· Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.

· Manage correspondence with insurance companies, physicians, specialists, and patients as needed.

· Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.

· Review accuracy and completeness of information requested and ensure that all supporting documents are present.

· Review denials and follow-up with provider to obtain medically necessary information to submit an appeal of the denial.

Skills/Competencies:

· Proven ability to manage multiple tasks.

· Ability to communicate effectively with all levels of the organization.

· Demonstrates a high level of professionalism, discretion, and confidentiality.

· Organizational skills.

Educational/Experience Requirements:

· High School diploma, GED, or equivalent required.

· One to three years of experience in prior authorization.

· One to three years of experience in medical billing a plus.

Notes:

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Health savings account
• Paid time off
• Vision insurance

Experience:

• Prior Authorization: 1 year (Preferred)
• Microsoft Excel: 1 year (Preferred)

Work Location: In person