Prior Authorization Specialist/Insurance Verification

SUMMARY:

Obtains information, insurance verification and authorization required for proper patient treatment and referrals.

ESSENTIAL DUTIES/RESPONSIBILITIES

Other duties may be assigned.

• Receive, track and obtain insurance authorization from in-network and out-of-network insurance carriers for New Patient and Follow-Up visits with our medical providers.
• Process physician referral orders. This includes obtaining any insurance authorization needed.
• Coordinate new therapy referrals for insurance plans that require authorization includes obtaining any insurance authorization needed.
• Accurately enter notes into Greenway PrimeSUITE regarding letters or correspondence from insurance companies regarding insurance authorization or other notifications. These documents should also be scanned into the appropriate patients chart in PrimeSuite.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Documents all interactions on an account and other duties as assigned.
• Verify and input insurance information obtained.
• Update accounts with appropriate information.

Physical Requirements Ability to sit and concentrate or extended periods of time. Frequent reaching and handling of reports and/or medical records. Ability to work under pressure and meet deadlines. Education, Experience and Certifications High School Diploma or GED required. CPC, CCS-P, RHIT or RHIA credential a plus. Knowledge of ICD-9 and 10-CM, CPT and HCPCS coding classifications systems required. 1 years coding experience for multiple specialties areas. Knowledge of medical terminology and anatomy and physiology required.

Job Type:

Full-time Pay:

$16.00 - $18.00 per hour

Benefits:

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

Experience:

Insurance verification: 1 year (Required)

Work Location:

In person