Pre-Authorization Specialist

Job Title : Pre-Authorization Specialist
Location : Remote
Duration : 6 Months

Job description:
About the role:

• The Pre-Authorization Specialist II is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department.

Your responsibilities will include:

• Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service
• Create electronic folders for new patients
• Organize patient medical records in preparation for prior authorization and appeals process
• Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling
• Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
• Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome
• Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
• Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
• Coordinates with lead and supervisor regarding complicated cases
• Quality Systems Duties and Responsibilities:
• Build Quality into all aspects of their work by maintaining compliance to all quality requirements.

Required qualifications:

• High School Diploma
• Minimum 2-3-years of recent Insurance Pre-Authorization experience. Must be recent experience!
• Experience working with various payors including, Medicare, Medicaid and Private Payor, as it relates to medical procedures, services, and devices
• Experience building effective relationships with internal and external customers.
• OT: Eligible for 1.40 OT Mark-Up: Yes

Job Type: Contract

Salary: $23.00 - $25.00 per hour

Work Location: Remote