Prior Authorization Representative

United States·Middleburg Heightsmid

Other

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Key Responsibilities

Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office.

Requirements Summary

Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office.

Technical Tools

Other

~1 min read

~1 min read

→Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office.
→Navigate through payer portals to initiate/obtain prior authorization status.
→Provide insurance company representatives with an overview of the services being submitted for prior authorization.
→Answer questions regarding the reimbursement process and direct testing specific and treatment questions.
→Complete LOMN (letter of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion.
→Follow up with the insurance company or physician’s office as needed.
→Meet benefit investigation process standards by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the task.
→Participate in team meetings by sharing the details of cases worked.
→Comply with all applicable SOPs.
→Meet or exceed productivity and quality KPI goals.
→Perform other duties as assigned.

Salary Range: $19-$22 per hour

Where is the job

Middleburg Heights, United States

On-site at the office

Who can apply

About this job

Pay per year: ≈ $39,520–$45,760 a year; 41% below the $72,800 median for Other jobs on Jobera (100,254 salaries).
Who can apply: United States
Posted: Today
Employer: has 24 open jobs on Jobera.