
Prior Authorization Specialist
5 days ago
Are you a detail-oriented professional seeking a new challenge in the healthcare industry? Look no further
This role is ideal for someone with excellent communication and organizational skills, as well as a strong understanding of insurance verification processes and payer/billing guidelines.
As a Prior Authorization Specialist, you will be responsible for:
- Reviewing and processing prior authorization requests for medical services, procedures, and medications
- Verifying insurance information and eligibility
- Handling patient inquiries regarding authorizations
- Providing necessary prior authorization documentation to patients for completion and signature
- Accurately documenting all patient, pharmacy, and insurance carrier interactions in EMR
- Coordinating with healthcare providers and insurance companies to obtain necessary authorizations
- Ensuring accurate and timely documentation of authorization requests and approvals
- Collaborating with the medical billing team to resolve any issues or denials
The ideal candidate should have:
- 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare
- Strong knowledge of insurance verification processes and payer/billing guidelines
- Excellent communication and interpersonal skills to work effectively with patients, providers, and insurers
- Detail-oriented with strong organizational skills
- Ability to work independently and meet deadlines
- Comfortable working in a remote, work-from-home setup
- Device (Desktop or Laptop)
- Processor:
- Windows Devices: Intel Core i5 (or higher) or AMD Ryzen 5 (or higher)
- Mac Devices: Apple M1 chip or newer
- RAM:
- Minimum of 8GB or higher for optimal performance
- Operating System:
- Windows: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). The operating system must have a legitimate license
- Mac: macOS compatible with M1 or newer chips
- Hard Disk:
- At least an SSD for faster processing and performance
- Internet Connectivity:
- Minimum speed of 50 Mbps via a wired connection for stability and reliability
- A backup internet connection is highly recommended
- Power Supply:
- A backup power supply (e.g., UPS or generator) to prevent disruptions during power outages
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