What are the responsibilities and job description for the Prior Authorization Specialist position at Cardiology Consultants of East Michigan?
Job Overview
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our team. This role is essential in ensuring that patients receive the necessary approvals for medical services and procedures. The ideal candidate will have a strong background in managed care, medical office operations, and a thorough understanding of medical coding and terminology. You will play a critical role in facilitating communication between healthcare providers and insurance companies while adhering to HIPAA regulations.
Responsibilities
- Review and process prior authorization requests for medical services and procedures.
- Verify patient insurance coverage and eligibility, ensuring compliance with managed care policies.
- Communicate effectively with healthcare providers, patients, and insurance representatives to gather necessary information.
- Utilize ICD-10 codes accurately for the submission of prior authorization requests.
- Maintain organized medical records and documentation in accordance with HIPAA standards.
- Assist in resolving any issues or denials related to prior authorizations by providing additional information as needed.
- Stay updated on changes in insurance policies, coding guidelines, and healthcare regulations.
Requirements
- Proven experience in a medical office setting or dental office environment is preferred.
- Strong knowledge of managed care processes and insurance verification practices.
- Familiarity with medical terminology, medical records management, and medical coding (CPT, ICD-10).
- Excellent organizational skills with attention to detail to ensure accuracy in documentation.
- Ability to communicate effectively both verbally and in writing with various stakeholders.
- Proficiency in using office software and electronic health record systems.
- A commitment to maintaining confidentiality and adhering to HIPAA regulations. Join our dedicated team as a Prior Authorization Specialist where your expertise will contribute significantly to patient care and operational efficiency.
Job Type: Full-time
Pay: $15.00 - $18.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $15 - $18