Prior Authorization Specialist-Primary Care- East Mason- Full Time

East MasonNormalmid

OtherPrior Authorization Specialist

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Quick Summary

Overview

This position will work 40 hours per week Prior Authorization Specialist Come work where we specialize in you! We have nearly 2,

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OtherPrior Authorization Specialist

This position will work 40 hours per week
Prior Authorization Specialist

Responsibilities

~1 min read

→Identify and obtain what is required for preauthorization of procedures, diagnostic tests, services and medications. Seeing the process through completion to minimize denial of claims.
→Coordinate with department providers and staff, coding/billing staff, and insurance representatives to ensure understanding of information needed to obtain proper authorization for payment within the appropriate timelines.
→Review and interpret insurance coverage and policy guidelines to determine authorization requirements.
→Communicate with patient as needed for procedures, diagnostic tests, services and medications to provide them with information regarding their coverage.
→Accurately document and communicate final determination in the patient's medical record and to appropriate staff, providers, or patient.
→Work with internal teams to identify and address trends or issues in the prior authorization process.
→Provide feedback and recommendations to improve prior authorization workflows and efficiency.

Requirements

~1 min read

High School Diploma and/or GED Required

1-3 years of experience working in a medical or insurance role Required

Hears Whispers < 3 feet - Constantly
Hears Whispers 3-8 feet - Constantly

Color Discrimination - Constantly
Near Vision (Correctable to Jaeger 2 or 20/40 binocular) - Constantly
Distance Vision (Correctable to Snellen chart 20/40 binocular) - Constantly

Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Display proficient telephone and computer skills with clear and professional speaking abilities.
Excellent organizational skills.
Excellent communication skills and follow through with internal and external customers.
Knowledge of insurance and medical terminology.
Basic knowledge of current CPT/ICD coding.
Able to provide exceptional customer service by assessing patient needs, meeting quality standards, and evaluating satisfaction.
Capable of being empathetic and responsive to patient’s needs by actively listening, asking appropriate questions, and continually looking for ways to provide assistance.
Able to efficiently multi-task and adapt to fast-paced environments with frequently changing protocols and processes.
Capable of effectively and positively interacting with staff members throughout the company.
Promote teamwork and provide a supportive environment throughout the organization.
Display grammar, spelling, and punctuation knowledge to accurately document patient information.
Able to work independently and think critically using provided information.