Prior Authorization Specialist

Responsibilities:
- Review and process Prior Authorization requests for medical procedures, treatments, and medications
- Verify insurance coverage and eligibility for requested services
- Obtain necessary medical records and documentation to support Prior Authorization requests
- Ensure compliance with HIPAA regulations and maintain patient confidentiality
- Communicate with healthcare providers, insurance companies, and patients to gather necessary information and resolve any issues or discrepancies
- Utilize medical coding knowledge (ICD-9) to accurately code procedures and diagnoses for Prior Authorization submissions
- Collaborate with the billing department to ensure accurate billing and reimbursement for authorized services

Skills:
- Strong knowledge of medical office procedures and workflows
- Proficiency in medical coding, including ICD-10 coding system
- Understanding of HIPAA regulations and ability to maintain patient confidentiality
- Experience in insurance verification and Prior Authorization processes
- Excellent organizational skills and attention to detail
- Effective communication skills, both written and verbal
- Ability to work independently and prioritize tasks effectively

Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of responsibilities, skills, or qualifications associated with the role.

Job Type: Full-time

Pay: $15.00 - $16.00 per hour

Expected hours: 40 per week

Weekly day range:

• Monday to Friday

Work Location: In person