Pre-Auth Specialist

Job Description

Job Description

We are looking for a dedicated Pre-Auth Specialist to join our team in East Brunswick, New Jersey. In this role, you will assist with obtaining pre-authorizations for radiology procedures while ensuring compliance with insurance requirements. This is a long-term contract position ideal for individuals who thrive in a fast-paced healthcare environment and possess excellent organizational and communication skills.

Responsibilities:
• Obtain and validate all required documentation to meet insurance company pre-authorization requirements.
• Coordinate with insurance providers via phone, electronic systems, and fax to secure timely approvals.
• Prioritize tasks effectively to handle urgent cases and maintain productivity standards of 40-50 submissions daily.
• Document verification and pre-certification notes accurately in the system to ensure seamless workflow.
• Address challenges proactively by communicating issues, potential impacts, and solutions to the management team.
• Deliver exceptional customer service to physicians, internal colleagues, and patients.
• Ensure compliance with insurance contracts and reimbursement guidelines.
• Collaborate with team members and managers to improve daily workflows and meet departmental goals.
• Stay updated on medical codes such as CPT, ICD-9, and ICD-10.
• Participate in training sessions and apply learned skills to enhance job performance.• Strong knowledge of medical terminology, including CPT codes and ICD-9/ICD-10.
• Experience with medical insurance verification and familiarity with insurance contracts.
• Proficiency in using electronic medical record systems and insurance websites.
• Effective communication skills, both written and verbal, with a focus on customer service.
• Ability to work efficiently in a high-volume, fast-paced environment.
• Strong problem-solving and time management skills with attention to detail.
• Self-motivated and capable of working independently while contributing to a team.
• Excellent computer skills and the ability to adapt quickly to new systems.