Prior Authorization Specialist

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