
Prior Authorization Coordinator
16 hours ago
We are seeking a highly skilled Prior Authorization Specialist to oversee the prior authorization process.
The successful candidate will be responsible for obtaining all types of prior authorizations and collaborating with patients, healthcare providers, pharmacies, and insurance carriers to ensure accurate information is gathered and processed efficiently.
Responsibilities:- Prior Authorization Processing: Review and process prior authorization requests for medical services, procedures, and medications
- Insurance Verification: Verify insurance information and eligibility
- Patient Communication: Handle patient inquiries regarding authorizations
- Document Management: Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
- Interaction Documentation: Accurately document all patient, pharmacy, and insurance carrier interactions in EMR.
- Collaboration and Coordination: Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
- Authorization Tracking: Ensure accurate and timely documentation of authorization requests and approvals
- Billing Support: Collaborate with medical billing team to resolve any issues or denials
- Knowledge Maintenance: Maintain up-to-date knowledge of insurance guidelines and procedures
- Additional Tasks: Complete other tasks as assigned by providers through EMR/EHR
- Administrative Support: Copy, fax, and mail documents and information as requested by insurance carrier
- Scheduling and Notifications: Schedule follow-up appointments, biologic injections, and photodynamic therapy treatments. Assist pathology department with notifying patients of pathology results via telephone
About this Role: The ideal candidate will possess excellent communication skills, attention to detail, and ability to work independently. They will also have a strong understanding of insurance guidelines and procedures, as well as experience working with electronic medical records.
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