Prior Authorization Specialist

Job Description

Job Description

Job Overview
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our team. This role is crucial in ensuring that patients receive the necessary medical services and treatments by obtaining prior authorizations from insurance companies. The ideal candidate will have a strong background in medical terminology, coding, and insurance verification, along with excellent communication skills to navigate the complexities of healthcare authorizations.

Duties

• Review and process prior authorization requests for medical procedures, tests, and medications.
• Communicate effectively with healthcare providers, patients, and insurance companies to gather necessary information for authorization.
• Verify patient insurance coverage and eligibility for requested services.
• Utilize medical coding systems such as ICD-10 to ensure accurate documentation of diagnoses and procedures.
• Maintain compliance with HIPAA regulations while handling sensitive patient information.
• Document all interactions and decisions in the medical records accurately.
• Collaborate with clinical staff to ensure timely submission of authorization requests.
• Follow up on pending authorizations and resolve any issues that may arise during the process.

Skills

• Strong understanding of medical terminology and coding practices.
• Experience in a dental or medical office setting preferred.
• Proficient in insurance verification processes and procedures.
• Familiarity with ICD-10 coding standards.
• Knowledge of HIPAA regulations to ensure patient confidentiality.
• Excellent organizational skills with attention to detail.
• Strong communication skills, both verbal and written, to effectively interact with various stakeholders.
• Ability to work independently as well as part of a team in a fast-paced environment.

If you are passionate about facilitating patient care through effective authorization processes and possess the required skills, we encourage you to apply for this vital role within our organization.

Job Type: Full-time

Pay: $20.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Ability to Commute:

• Morristown, NJ 07960 (Required)

Ability to Relocate:

• Morristown, NJ 07960: Relocate before starting work (Required)

Work Location: In person