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Prior Authorization Specialist I
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Job Description
- Req#: 47072
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $30.97 per hour
- Generous total compensation package including benefits such as medical, dental, and vision coverage
- Opportunities for career advancement and professional development
- Remote work flexibility, allowing you to work from anywhere
- Supportive work environment with a focus on high-quality patient care
- Engaging role that involves collaboration with various stakeholders in the healthcare system
What to Expect (Job Responsibilities):
- Process and prioritize incoming prior authorization requests and authorize specified services as per departmental guidelines
- Collaborate with patients, providers, and departments to obtain necessary information and payer permissions prior to scheduled services
- Maintain and monitor accounts for financial clearance, ensuring compliance with insurance requirements
- Answer ACD line calls, verifying member eligibility and providing information on network providers and available benefits
- Act as a liaison between physicians and payers for peer-to-peer reviews when needed
What is Required (Qualifications):
- High school diploma or GED required; Associate's Degree or higher preferred
- 4-5 years of office experience in a high-volume data entry office, customer service call center, healthcare office, or hospital administration
- Experience using insurance payer websites and familiarity with insurance verification and prior authorization processes
- Strong oral and written communication skills with the ability to maintain confidentiality of sensitive information
- Must demonstrate strong organizational skills and the ability to multitask in a fast-paced environment
How to Stand Out (Preferred Qualifications):
- Bilingual candidates are preferred
- Knowledge of medical terminology and ICD-9/CPT coding
- Experience with Epic or similar healthcare systems
- Previous customer service experience in a healthcare setting
- Ability to maintain a high accuracy rate while processing a large volume of requests
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