What are the responsibilities and job description for the Prior Authorizations Rep (30486) position at GI Alliance?
Description
Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals throughout Arizona.
Requirements
Physical Requirements:
Requires sitting for extended periods. Some bending, stretching, and stooping required. Manual dexterity enough to use a keyboard and calculator. Normal range of hearing and vision and verbal communication is required. Use of a telephone is required.
Performance Requirements
Knowledge of billing and insurance practices and procedures as well as regulations including Medicare, Medicaid, and third-party insurance companies including managed care contracts. Knowledge of current ICD-10 and CPT codes is required. Strong communication skills are required.
Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals throughout Arizona.
- Review EMR chart messaging and review schedules daily for upcoming surgical & in-office procedures
- Review chart documentations to ensure patient meets medical policy guidelines
- Prioritize authorization requests according to urgency
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Verify coverage and benefits and calculate any out-of-pocket portions due
- Contact patients to review any out-of-pocket portions due prior to surgery
Requirements
- Minimum 1 year prior authorization experience
- Understanding of payer medical policy guidelines to manage authorizations effectively
- Proficient use of CPT and ICD10 codes
- Detail-oriented and above-average organizational skills
- Plans and prioritizes to meet deadlines
- Ability to multitask and remain focused while managing a high volume, time-sensitive workload
- Urology experience helpful
Physical Requirements:
Requires sitting for extended periods. Some bending, stretching, and stooping required. Manual dexterity enough to use a keyboard and calculator. Normal range of hearing and vision and verbal communication is required. Use of a telephone is required.
Performance Requirements
Knowledge of billing and insurance practices and procedures as well as regulations including Medicare, Medicaid, and third-party insurance companies including managed care contracts. Knowledge of current ICD-10 and CPT codes is required. Strong communication skills are required.