Prior Authorization Specialist

We are looking for a dynamic and friendly prior authorization specialist with a minimum of 1-2 years’ experience. This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, ordering medications, and scheduling appointments for treatment within our clinics.

Qualifications and Skills:

• Organized and detail oriented.
• Excellent time management skills
• Verify insurance coverage and eligibility.
• Review of procedure orders and documentation to determine necessity of prior auth.
• Strong communication skills with providers, team members and patients
• Excellent written communication skills
• Detailed documentation of authorization numbers and process for each prior auth
• Maintain accurate patient medical records.
• Provide advice and emotional support to patients and their family members.
• Knowledge of Microsoft Office
• Excellent Customer Service

What We are Looking For:

• The ability to build rapport with patients is essential.
• A willingness to be flexible and adapt as situations require.
• Ability to remain calm if patient becomes distressed.
• Personable, optimistic, resilient and possess exceptional interpersonal communication skills.
• Excellent written and spoken grammar and typing skills.
• EMR/EHR experience is a plus.
• Keen attention to detail.
• Ability to take direction and correction as needed.
• Performs other related duties as required or assigned.
• Follows written and verbal communications.
• Document all account activity and correspond to inquiries in a timely manner.
• Provide outstanding customer service to patients and develop and maintain positive working relationships with internal and other external customers.
• Verify prior authorizations and/or pre-service requirements are met.

Requirements:

• High school diploma/ GED required.
• Minimum of 1-2 years’ experience required.
• The job is full-time (in the office regular and consistent attendance is required)