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Prior Authorization Specialist
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Emerald Coast Health Alliance
Fort Walton Beach, FL (In Person)
$36,920 Salary, Full-Time
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Job Description
THIS IS NOT A REMOTE POSITION.
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 providers. The ideal candidate will have a strong understanding of medical coding, insurance verification, and managed care processes, along with a commitment to maintaining compliance with HIPAA regulations. Responsibilities Review and process prior authorization requests for medical services and procedures. Verify patient insurance eligibility and benefits through effective communication with insurance companies. Utilize ICD-9 and ICD-10 coding systems to accurately document diagnoses and procedures. Collaborate with healthcare providers, including dental offices and medical offices, to gather necessary information for authorization requests. Maintain accurate records of all authorization requests and follow up on pending approvals. Ensure compliance with HIPAA regulations throughout the authorization process. Assist in resolving any issues or discrepancies related to prior authorizations. Stay updated on changes in managed care policies and procedures that may affect authorization requirements. Requirements Previous experience in a healthcare setting, preferably in a role related to prior authorizations or medical coding. Proficiency in ICD-9 and ICD-10 coding systems is essential. Familiarity with insurance verification processes and managed care principles. Strong attention to detail and excellent organizational skills. Ability to communicate effectively with healthcare providers, patients, and insurance representatives. Knowledge of HIPAA regulations to ensure patient confidentiality is maintained. Experience medical office environment is preferred Monday- Friday, 7am
- 4pm•starting pay $17-18.