Prior Authorization Representative Job Description
Client Profile - An Indiana based Independent Physician-Owned radiology practices founded in 1967 .
Job Summary - Prior Authorization Representative is responsible for securing inpatient/outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorizations before service are rendered . Must be comfortable working with clinical professionals.
Job Duties
Verify insurance eligibility, benefits, network status and create pre-service liability estimate.
Ensure accurate ICD, CPT codes and related medical records are submitted in the authorization request.
Secure prior authorizations of inpatient and outpatient imaging.
Acts as a liaison between the payer and clinic schedulers/medical support.
Follows up on delayed or denied authorizations requests and escalates for resolution.
Create detail documentation and maintain /stores the authorization paper trail.
Qualifications
High School Diploma, 3+years of experience in a health care financial setting or medical office setting. Must have previous prior authorization experience.
Excellent customer service skills, strong attention to details, multi-task as needed.
Must be familiar with an EMR or HER; Microsoft Office 365
Must be able to take responsibility and work under pressure . Work efficiently in a busy medical office.
Must be a positive team player.
K nowledge of ICD-10, CPT, and HCPCS codes specific to radiology is a plus.
Proficient in medical terminology, especially radiological terms and procedures.
Days/Hours: M/F 8a to 5pm (Availability to start as early as 7a and work as last as 6:00pm is a plus)
Starting pay $20 .00 to $21 .00 hourly (Based on experience)
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