Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

We are hiring for a full-time Authorization Representative. The applicant should have knowledge in the following areas:
Verify insurance eligibility
Verify co-insurance and/or out-of-pocket costs for procedures
Review clinic notes and that they are properly documented based on the procedure needing authorization
Verify guidelines and that proper documents are gathered based on each procedure. Eg: clinic note documentation, orders, imaging
Obtain prior authorization via insurance portals or by calling for procedures and imaging
Submit appeals for denied procedures as deemed necessary
Conduct peer to peer review with doctors as needed
Work with procedure scheduling to ensure procedures are being scheduled accordingly based on whether we obtained authorization.
Proper documentation of approved/denied procedures and imaging requests.