Prior Authorization Specialist Kansas Gastroenterology - 3.4 Wichita, KS Job Details Full-time From $20 an hour 18 hours ago Benefits Disability insurance Health insurance Dental insurance 401(k) Paid time off Vision insurance Life insurance Qualifications Writing skills High school diploma or GED Pre-authorization review for utilization management Attention to detail Clinical information systems Medical billing and coding communication with insurance companies Coordinating with insurance clients Medical terminology

Full Job Description Job Title:

Prior Authorization Specialist Department:

Business Office Immediate Supervisor:

Billing Office Supervisor Job Responsibilities:

Responsible for all aspects of the prior authorization process. Responsibilities include collecting all the necessary documentation, contacting the patient as needed for additional information and completion of the required prior authorization for procedures and tests ordered by the provider. Experience with infusion prior authorizations a plus.

Examples of Duties:

(This list may not include all of the duties assigned.) 1. Use of prior authorization software and payer websites for majority of work. Must have familiarity with EMR systems, payer websites, and electronic communication. 2. Follow up with insurance carriers for prior authorization or precertification as needed. 3. Submit clinical information to insurance for prior authorizations, pre-certs and pre-determinations when requested. 4. Attention to detail and ability to maintain accurate notes in all systems related to any prior authorization initiated and ongoing process. 5. Effective and timely communication, both internal and external.

PERFORMANCE REQUIREMENTS

Knowledge, Skills and Abilities:

1. Knowledge of billing and EMR systems. 2. Knowledge of organizational policies, regulations and procedures. 3. Understand insurance policies in regard to benefits, pre-certifications, prior authorizations, etc. 4. Skill in establishing and maintaining effective working relationships with insurance carriers, PCP offices and internal staff. 5. Ability to react calmly and effectively in stressful situations. 6. Ability to interpret, adapt and apply guidelines and procedures. 7. Ability to communicate clearly verbally and in writing.

Education:

High School Graduate Experience:

Clinical knowledge and terminology along with a strong insurance background.

Pay:

From $20.00 per hour

Benefits:

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

Work Location:

In person