Southwestern Colorado ENT is growing!! We are looking for an additional Eligibility/Prior Auth Representative to help support our team. The ideal candidate will have experience in the healthcare industry and a strong understanding of prior authorization, insurance eligibility, and referral screening processes. With at least 3 years' experience in the position. The successful candidate will be responsible for reviewing referrals, verifying patient insurance eligibility and assisting in processing prior authorization requests both surgical and clinical. This is an excellent opportunity for someone who is dependable, can work independently and is detail oriented.

Responsibilities:

• Verify patient eligibility and benefits.
• Review medical records for accuracy and completeness.
• Process prior authorization requests in accordance with applicable laws and regulations for both surgical procedures and clinic appointments.
• Communicate with providers, insurance companies, and other stakeholders regarding prior authorization requests.
• Maintain accurate documentation of all prior authorization activities.
• Monitor changes in insurance policies and procedures to ensure compliance.
• Provide customer service to patients, providers, and other stakeholders.

Qualifications
- Office experience
- Medical terminology
- Medical records
- Medical coding
- Insurance verification
- Managed care
- Medical office experience
- HIPAA
- CPT coding
- ICD-9, ICD-10, ICD coding

Job Type: Part-time

Pay: $22.00 per hour

Expected hours: 16 – 24 per week

Benefits:

• Flexible schedule

Weekly day range:

• No weekends

Experience:

• Insurance verification: 3 years (Required)
• Medical office: 1 year (Preferred)

Work Location: In person