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WC
Washington County Hospital and Clinic
Prior Authorization Specialist
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Job Description
DUTIES/RESPONSIBILITIES
(include but are not limited to the following)- Reviews and processes all assigned prior authorization requests to completion. Diligently reviews patient health care data, diagnostic testing and treatment information for completeness for insurance requirements and prior authorization process.
- Communicates with providers, and clinical staff as needed to obtain and understand clinical documentation requirements. Provide required clinical documentation to payers via phone, faxed forms, and/or website.
- Maintains documentation of authorization approvals and denials, including authorization numbers and associated codes, dates, and other relevant data
- Communicates effectively with clinical staff, payor representatives, and providers
- Recommends process improvements for increased efficiencies
- Display and promote company values
- Regular attendance
- Other projects as needed