Job Description

JOB TITLE: Pre-Authorization Specialist
DEPARTMENT: Business Office

GENERAL SUMMARY OF DUTIES:
This nonexempt position is responsible for obtaining pre-authorization for all Office Visits, Cardiac device services, Imaging, In-Patient, Out- Patient, Catheterization Lab, and ASC (Ambulatory Surgery Center) procedures. This job requires the application and interpretation of insurance medical and payment policies and procedures. The individual must act as an on-site liaison for all departments, referring providers, insurance carriers, and patients for all eligibility and pre-authorization/certification functions. Communicating coverage/benefit determination to patient either in-person or via phone.

ESSENTIAL FUNCTIONS: (This list may not include all of the duties assigned.)

• Responsible for obtaining prior-authorization for all office visits, cardiac device services, imaging, In-Patient/Out- Patient procedures and services, all ASC (Ambulatory Surgery Center) services for all payer types in a timely manner.
• Collaborates with all team members and departments, including external providers, to ensure all patient demographic information and clinical notes are acquired prior to initiation of the prior-authorization process.
• Acts as on-site liaison for the ancillary and clinical departments to internal and external referring providers, insurance carriers, as well as patients
• Review patient eligibility, update patient demographics, document patient’s preferred facility.

EMPLOYEE BENEFITS:

• Medical
• Dental
• Vision
• Colonial Life Elective Benefits
• Life Insurance
• Profit Sharing 401K
• HSA
• FSA
• Employee Assistance Program
• Wellness Program
• PTO- starting at up to 5.84 hours per pay period (increases with years of service)
• 8 paid holidays per year
• FMLA

EDUCATION: Some college preferred. Minimum: High school diploma or equivalent
Preferred Certificate/License: Certified Professional Coder (CPC) required from AAPC
Experience: Minimum: One year of experience in medical office with emphasis in commercial and government prior-authorization requirements.

I look forward to speaking with you.

Respond with a copy of your current CV/resume or send it to jkeleb@samuelstaffing.com along with the best time to reach you. I will reach out to you directly so we can talk more about this opportunity, discuss the next steps, and get an interview set up with our clinic manager. If you're busy, feel free to send me a text at (480) 479-0233 and we can set up a time to chat. Thank you!

Have a blessed day!

Best regards,
Jenna Keleb, Senior Recruiter
jkeleb@samuelstaffing.com

Job Tags

Holiday work, Full time,

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