Hiring Manager: [[Roberta Schultz]]
Recruiter: [[Susan Blair]]
About the Role:
Prior Authorization Specialist is a position within our Houston Based -Boston Scientific Cardiac Diagnostic revenue cycle team that works with insurance and patients regarding their cardiac diagnostic services claims.
- Verifies patient insurance coverage timely utilizing phone or online resources.
- Ability to complete a high Volume of authorizations in timely matter via payer specific portals and vendors
- Ensures all pertinent medical documentation is accurate and present prior to authorization submission.
- Follows up with pending authorizations on a regular basis to obtain the status or to be informed of any action needed in order to obtain the authorization approval.
- Outstanding Phone communication skills.
- Participates in educational activities and attends regular staff and department meetings.
- Exhibit and manage excellent turn-around time in order to ensure timely authorizations.
- Consistently work in a positive and cooperative manner with fellow team members and management.
- Demonstrate flexibility to perform duties wherever volume deems it necessary.
- Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.
- Document activities appropriately in process notes.
- Possess a strong work ethic and a commitment to improving patients’ lives.
- Complies with all company and department policies and procedures.
- Enjoys problem-solving in a dynamic, fast paced, team based and rapidly changing environment.
- 3-5 years of experience working in prior authorization, medical billing, health insurance or collections with demonstrated results.
- Good problem solving and decision-making skills.
- Excellent customer service and phone skills.
- Excellent time management, organizational, communication, multitasking and teamwork skills.
- Working knowledge of ICD-10, CPT and HCPCS coding.
- Ability to successfully navigate between multiple systems throughout the course of the workday this includes but is not limited to billing software, and payer portals.
- Experience using Microsoft applications i.e. (Dynamics 360, Outlook, Teams and Xifin) preferred but not required
Requisition ID: []