
Medical Services Coordinator
11 hours ago
A Prior Authorization Specialist plays a crucial role in the healthcare industry, ensuring that medical services, procedures, and medications are authorized before they can be administered to patients. The specialist is responsible for reviewing and processing prior authorization requests, verifying insurance information and eligibility, handling patient inquiries, and providing necessary documentation to patients.
Responsibilities:- Review and process prior authorization requests
- Verify insurance information and eligibility
- Handle patient inquiries regarding authorizations
- Provide necessary documentation to patients for completion and signature
- Accurately document all interactions with patients, pharmacies, and insurance carriers
- Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
- Ensure accurate and timely documentation of authorization requests and approvals
- Collaborate with medical billing team to resolve any issues or denials
- Maintain up-to-date knowledge of insurance guidelines and procedures
- Complete other tasks as assigned by providers through electronic health records (EHR)
- Proven 3-5 years of experience as a Prior Authorization Specialist
- Strong knowledge of insurance verification processes and payer/billing guidelines
- Excellent communication and interpersonal skills
- Detail-oriented with strong organizational skills
- Ability to work independently and meet deadlines
- Comfortable working in a remote setup
- Amenable to work in a graveyard shift
The ideal candidate will have excellent communication and interpersonal skills, with the ability to work effectively with patients, healthcare providers, and insurance companies. They will also possess strong organizational skills, attention to detail, and the ability to meet deadlines. Experience in the healthcare industry, particularly in prior authorization, is highly desirable.
This role requires a high level of accuracy and attention to detail, as well as the ability to manage multiple priorities and deadlines. The successful candidate will be able to work independently and as part of a team, with excellent communication and problem-solving skills.
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