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Prior Authorization Specialist

Posted: July 29, 2024
Salary:US$16.00 - US$19.00 per year + Medical/Dental/Vision/Sick Pay/401k
Location:Tomball
Job type: Permanent
Discipline:Allied
Reference:231824_1722313353
Work Location:On-site

Job description

  • Verifying insurance coverage: Confirming that a procedure or service is covered by the insurance company
  • Not sitting at the front desk or having any in person conversations with patients, solely doing prior auths/insurance verification/some referrals
  • Collecting and documenting benefits: Gathering insurance benefits and authorization requirements
  • Obtaining authorizations: Securing authorizations for medications, medical devices, outpatient services, and referrals
  • Communicating with insurance providers: Notifying the rendering party as soon as possible so the patient can receive the services they need
  • Tracking the status of requests: Following up on requests from initial submission until the final insurance determination
  • Collects co-pays and posts charges.
  • Charge entry and patient balance processing.
  • Distributes information to patients regarding office policies, procedures, information about the practice, etc.
  • Explain and enroll patients in the patient portal.
  • Additional responsibilities as needed
  • Assist with answering inbound phone calls and providing solutions
    • May include scheduling, insurance verification, etc
3-5 Must Have Skills/Qualifications
  • At least 2 years of Medical Office insurance authorization experience required.
  • Experience processing authorization requests for medications, procedures, office visits via payer website or by phone and follow-up regularly on pending cases
  • Great communication skills
  • Detail Oriented