Prior Authorization Representative

Prior Authorization Specialist needed for a multi doctor Medical Practice

* 1 year experience preferred, but will train the right candidate

· Obtains authorizations for x-rays, sonograms, cat scans. MRI and PET scans.

· Utilizes a high degree of accuracy in obtaining and verifying that registration, demographic and insurance information is correct and up to date.

· Transmitting clinical documentation on-line or via fax ensuring strict confidentiality of all health records, member information and follows HIPAA guidelines.

· Proper telephone etiquette answering telephone calls and voicemails to address patient needs.

· Proficient with ICD- 10 and CPT coding.

· Completes all administrative functions related with authorization activities in an efficient manner.

· Preparing letters of medical necessity for denied cases.

· Schedules peer to peer discussions with Physician/PA

· Performs duties in honest and ethical manner.

· Perform other duties as assigned.

Must demonstrate a positive demeanor, good verbal and written communications skills, and be professional in appearance and approach.

Job Type: Full-time

Job Type: Full-time

Pay: $18.00 - $19.00 per hour

Benefits:

• Paid time off

Weekly day range:

• Monday to Friday

Work Location: In person