Job Description
Description:
The Prior Authorization Specialist plays a critical role in the healthcare system by ensuring that patients receive the necessary medical services and treatments in a timely manner. This position involves reviewing and processing prior authorization requests from healthcare providers, verifying patient eligibility, and collaborating with insurance companies to facilitate approvals. The ideal candidate will possess strong attention to detail, excellent communication skills, and a solid understanding of medical terminology and coding.
Duties
· Review and assess prior authorization requests for medical procedures, services, and medications.
· Verify patient eligibility and benefits with insurance providers.
· Communicate effectively with healthcare providers to obtain necessary documentation for authorization.
· Utilize ICD-10 coding systems to accurately process requests.
· Maintain accurate records of all prior authorization activities in the medical office or managed care environment.
· Collaborate with other healthcare professionals to ensure compliance with regulations and policies.
· Stay updated on changes in insurance policies, medical coding practices, and managed care guidelines.
Schedule:
· 8:30AM to 5:00PM
· Monday - Friday
Requirements:· Proficiency in medical terminology and understanding of medical records management.
· Experience with office operations in a medical or dental office setting.
· Knowledge of ICD-10 coding systems is essential.
· Familiarity with managed care processes and protocols.
· Strong organizational skills with the ability to manage multiple tasks simultaneously.
· Excellent verbal and written communication skills for effective interaction with providers, patients, and insurance representatives.
· Attention to detail to ensure accuracy in processing prior authorizations.
This position requires a dedicated professional who is committed to providing quality service within the healthcare system while ensuring that patients receive the necessary approvals for their treatments.
...seeking professionals to become a State Farm independent contractor agent in SAINT LOUIS, MISSOURI to take over an existing book of... ...where to start, this could be the opportunity for you. No prior experience as an insurance agent is required. As an agent, your daily actives...
...Description Summary: Operates all cath lab equipment and digital processing equipment. Performs all cath lab duties such as scrub assistant, X-ray equipment operation and digital processing as indicated. Contributes to the general operation of the department by...
...Job Title: HSE Manager (Health, Safety & Environment) Location: Marietta, GA Position Overview: We are urgently seeking a highly skilled and proactive HSE Manager to support ongoing construction and demolition activities at an industrial site in Marietta, GA....
...Information Security Analyst Responsibilities: Monitor computer networks for security issues. Investigate security breaches and other cybersecurity incidents. Install security measures and operate software to protect systems and information infrastructure, including...
...Ready to join a team of new, innovative healthcare providers devoted to improving the lives of our senior members? Our client is seeking... ...-focused community. Job Summary: Membership Sales Consultants are the primary outreach for our client and grow our patient...