PSR / Prior Authorization Specialist

Full-Time front office administrative work, 30-40 hours per week. Includes entering referrals, scheduling, verifying insurance benefits, and other administrative tasks.

Duties include but not limited to:

• Call and schedule referred patients.
• Obtain insurance benefits quotes.
• Calculate estimate of patient responsibility for procedures (inpatient, outpatient, and in office procedures).
• Obtain medical records clearances, lab results, and other required patient information to send to the appropriate facility for surgery clearances.
• Obtain insurance prior authorization for medications
• Verifying criteria: Checking patient charts against insurance and evidence-based guidelines.
• Assessing necessity: Confirming diagnoses, lab results, and previous trial treatments (step therapy).
• Identifying alternatives: Recommending preferred formulary options if a request is restricted.
• Request Submission and Tracking
• Completing paperwork: Filling out specific payer request forms with exact codes, drug strengths, and durations.
• Submitting data: Sending clinical notes and letters of medical necessity via electronic portals or fax.
• Managing timelines: Monitoring pending cases and responding to requests for additional information.
• Communication and Coordination
• Liaison work: Acting as the contact point between doctor offices, retail or specialty pharmacies, and insurance companies.
• Handling appeals: Assisting with denial overturns by gathering extra proof when treatments are rejected
• Informing patients: Updating individuals on approval statuses and potential delays in therapy.
• APPEALS Processing
• Other administrative duties as assigned to support clinic operations.

Requirements:

• High school diploma or equivalent.
• Reliable, punctual, and committed to quality patient care.
• Two or more years’ experience with EPIC medical records systems.
• Front office EPIC SuperUser experience preferred.
• Exceptional work ethic and willingness to take ownership of assigned tasks.
• Microsoft application skills: Word, Excel, and Outlook.
• Data entry skills.
• Excellent customer service skills.
• Excellent organizational skills, with high attention to detail and accuracy.
• Knowledge of medical terminology preferred.
• Knowledge of insurance payors in Washington State preferred.
• Skilled in using email, fax, scanner, photocopier, and phone systems (preferably Zoom).
• Pleasant and clear communication skills.
• Ability to work well under pressure and time constraints.
• Demonstrated ability to manage multiple tasks simultaneously.
• You must be able to provide proof of legal authorization to work in the United States.

Benefits:

We offer a family friendly and people-focused workplace, plus the opportunity to work for the best healthcare company in Washington.

Full Time employee benefits:

· 9 paid holidays

· 401(k)

· 401(k) matching

· Dental insurance

· Disability insurance

· Health insurance

· Health savings account

· Life insurance

· Paid time off

· Sick time accrued per WA State law

· Paid training

· Retirement plan

· Vision insurance

Our staff not only enjoys benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement, and collaboration. We are interested in learning more about you and appreciate you taking the time to apply online.

Hours: Full Time, 30-40 hours per week, Monday to Friday. No evenings or weekends.

Eventual remote work possible.

Salary: Hourly wage $25 per hour.
To Apply: Please send a cover letter and resume to: careers@wwmedgroup.com.

• Western Washington Medical Group is an Equal Opportunity Employer. We celebrate diversity and inclusion and welcome applications from qualified candidates, regardless of race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected veteran status or any other characteristic protected by applicable federal, state or local law.

Pay: From $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $25