Prior Authorization Specialist

Overview

Join our dynamic healthcare team as a Prior Authorization Specialist, where your expertise will streamline the approval process for medical services and treatments. In this vital role, you will act as a key liaison between healthcare providers, insurance companies, and patients to ensure timely and accurate authorization of medical procedures. Your attention to detail, knowledge of insurance policies, and commitment to patient confidentiality will drive efficiency and enhance patient care experiences. This position offers an energetic environment where proactive communication and problem-solving are celebrated as essential skills for success.

Duties

• Review medical documentation and verify insurance coverage to initiate prior authorization requests efficiently.
• Collaborate with healthcare providers to gather necessary clinical information, including CPT coding, ICD-9, ICD-10, and ICD coding details.
• Submit authorization requests through electronic health records (EHR) systems or managed care portals, ensuring accuracy and completeness.
• Follow up with insurance carriers regularly to track approval status and expedite processing times.
• Maintain detailed records of all authorization activities in compliance with HIPAA and clinical confidentiality policies.
• Communicate clearly with patients and healthcare teams regarding authorization statuses, required documentation, or additional steps needed.
• Stay updated on health insurance policy changes, managed care procedures, and industry best practices to optimize workflow.

Skills

• Strong understanding of HIPAA regulations and medical confidentiality policies to protect patient information at all times.
• Proficiency in CPT coding, ICD-9, ICD-10, ICD coding, and medical terminology essential for accurate documentation.
• Experience with electronic health records (EHR), EMR/EHR management systems, and Microsoft Office suite for daily operations.
• Knowledge of health insurance policies, managed care processes, insurance verification, and prior authorization procedures.
• Excellent customer service skills with the ability to communicate effectively with providers, insurance representatives, and patients.
• Background in medical office or dental office environments preferred; familiarity with medical billing and medical records management is a plus.
• Ability to multitask efficiently in a fast-paced setting while maintaining attention to detail and clinical confidentiality.

This role is perfect for motivated professionals eager to make a meaningful impact in healthcare administration by ensuring smooth authorization workflows that support quality patient care!

Pay: From $18.00 per hour

Benefits:

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

Work Location: In person

Salary : $18