What are the responsibilities and job description for the Referrals & Prior Authorization Representative position at Astera Health?
Astera Health is looking to hire a Referrals and Prior Authorization Representative. This role is responsible for determining if patient procedures require authorization, review medical necessity policy when applicable, and/or determine if other requirements need to be done prior to service of the patient.
This is a full-time position scheduled at 40 hours per week, Monday - Friday 8:30am - 5:00pm. Astera Health offers a comprehensive benefits package including health, dental, vision, life insurance and retirement. We also support work-life balance through benefits such as paid time off, short and long-term disability and our employee wellness initiative.
Responsibilities required include, but are not limited to:
- Works Prior Authorization work queues as assigned. Determines if procedure/service needs or requires authorization. May also include follow-up with insurance companies on denial(s) or no-pay.
- Investigation / research for new organizational services to determine if Prior Authorization is required per insurance guidelines.
- Contacts insurance company to obtain approval for procedure/service.
Competencies required:
- Ability to effectively operate standard office equipment and software including Electronic Medical Record (EPIC)
- Ability to communicate effectively, both orally and in writing
- Strong computer and telephone skills
- Commitment to providing excellent patient care and overall experience
Education and experience required:
- Post-secondary education in Medical Coding, Medical Administrative Assistant, or related field
- 2 years experience in prior authorization
- Office experience in medical facility
- Or combined years of relevant education and experience to perform the essential duties of this position
Astera Health is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.