What are the responsibilities and job description for the Prior Authorization Specialist position at Plastic + Hand Surgical Associates?
Plastic Hand Surgical Associates is a leading reconstructive, hand and cosmetic surgery physician practice. Our day surgery center is fully accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). We provide patients with individualized care in a comfortable, private setting.
We’re excited to announce an opportunity for an experienced Prior Authorization Specialist to join our team at our brand-new, state-of-the-art facility in the Rock Row Medical Campus!
Responsibilities include:
- Prioritize incoming authorization requests and initiate them through phone, mail, fax or 3rd party portals/sites.
- Review accuracy and completeness of information requested and ensure that all supporting documents are present.
- Validating eligibility and benefits
- Create accurate and consistent documentation in patient’s records to ensure that pre-authorization information is properly updated.
- Notify the necessary parties within the required timeframe for routine and urgent requests for services.
- Provide cost estimates to patients and obtain payments as required.
- Manage correspondence with insurance companies, physicians, specialists and patients as required.
- Manage denials and submit appeals to get them approved from insurance companies.
- Maintain extensive working knowledge and expertise of insurance companies and billing authorization requirements.
- Communicate any insurance changes or trends back to management and the scheduling team.
- Other duties within the billing department as needed
The successful candidate will have a minimum of 2 years' experience performing surgical prior authorizations, as well as OT/PT, Medication, and Imaging prior authorizations. Candidate should also have a good understanding of procedure coding.
This position offers the possibility for hybrid work after a successful training period.
Job Type: Full-time
Pay: $23.00 - $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Surgical Prior Authorization: 2 years (Required)
Ability to Commute:
- Westbrook, ME 04092 (Required)
Work Location: Hybrid remote in Westbrook, ME 04092
Salary : $23 - $25