PRIOR AUTHORIZATION SPECIALIST- REMOTE POSITION-FT
About the position
Responsibilities
• Obtains prior authorizations/pre-certification per payer requirements for physician ordered procedures.
• Verifies physician orders, authorization, and demographic information before sending to the hospital scheduling department.
• Maintains communication with providers, clinical staff, and patients regarding authorization status.
• Assists the billing department in researching and resolving rejected, incorrectly paid, and denied claims.
• Stays current with insurance requirements for prior authorizations and provides education within the department and to clinical staff.
• Maintains efficient tracking of all pending authorizations to ensure timely resolution.
• Performs other duties as assigned.
Requirements
• Must be at least 16 years of age (21 for driving positions).
• Must be able to legally work in the United States.
• Must be able to pass a background check.
• Must be able to pass a drug screen and breath alcohol test (if applicable).
• Must complete employee health meeting.
• High School Diploma or equivalent preferred.
• Past knowledge of CPT, HCPCS, and ICD-10 codes.
• Past knowledge of Medical Terminology.
• Past experience in the prior authorization process.
• Past experience with Microsoft Office to include Word, Excel, and PowerPoint helpful.
• Data entry experience.
Nice-to-haves
• Bilingual.
Benefits
• Medical
• Dental
• Life
• Retirement
• Paid Time Off
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