Prior Authorization Specialist

Description:

• Contact insurance carriers to verify patient's insurance eligibility, benefits, and authorization requirement.
• Secure prior authorizations before services are performed.
• Communicate insurance changes/trends to team and leadership.
• Document all communications/contacts with providers and other personnel.
• Prioritize time sensitive authorizations.
• Maintain proficiency in multiple EMR systems for demographics, insurance, and clinical information.
• Demonstrate proficiency in digital faxing, scanning, and instant messaging communication tools.
• Other roles and responsibilities as assigned.

Requirements:

Education and Experience:

• High school graduate or equivalency.
• Certification through NAHAM, HFMA, AHIMA and Associates Degree preferred
• Minimum of two years’ experience in a clinic/hospital billing, prior authorization, and/or insurance verification area, w/demonstrated payer knowledge preferred.

Skills/Abilities:

• Demonstrated communication and customer service skills.
• Ability to follow oral or written instructions.
• Ability to organize and interpret data; judgment, tact, diplomacy and the ability to problem solve.
• Work effectively in a team environment; communicate with a variety of professionals
• Knowledge of computers and software required

Physical Requirements:

• Work is of light demand.

Benefits:

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Retirement
• Paid Time Off
• Tuition Reimbursement
• Health Savings Account
• Wellness Program
• Employee Assistance Program