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Prior Authorization Specialist
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Ohio Valley Pain Institute
Louisville, KY (In Person)
$43,680 Salary, Full-Time
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Job Description
Prior Authorization Specialist Ohio Valley Pain Institute Louisville, KY Job Details Part-time | Full-time $20 - $22 an hour 17 hours ago Benefits Health savings account Health insurance Dental insurance 401(k) Paid time off Qualifications Record keeping Customer communication Electronic health records (EHR) management Medical insurance coverage verification Medical office experience HIPAA Medical coding guidelines Health information regulatory compliance Organizational skills Patient interaction Health information management Clinical confidentiality policies Document management Managing patient records Medical terminology Full Job Description Overview Join our dynamic healthcare team as a Prior Authorization Specialist, where your expertise will streamline the approval process for medical services and procedures. In this vital role, you will serve as the key liaison between healthcare providers, insurance companies, and patients to ensure timely authorization of treatments. Your proactive approach and attention to detail will help facilitate seamless patient care while maintaining compliance with industry regulations. If you thrive in a fast-paced environment and are passionate about improving healthcare access, this opportunity is perfect for you! Responsibilities Review and analyze medical documentation to determine insurance coverage eligibility for procedures and treatments Prepare and submit prior authorization requests to insurance carriers accurately and efficiently Follow up with insurance companies to track approval statuses, resolve issues, and expedite processes Maintain detailed records of authorization requests, approvals, denials, and related correspondence in accordance with HIPAA regulations Collaborate with medical offices, providers, and insurance representatives to clarify requirements and resolve discrepancies Utilize medical coding knowledge including CPT (Current Procedural Terminology), ICD-9, ICD-10 (International Classification of Diseases), and ICD coding systems to support accurate submissions Verify insurance benefits and coverage details prior to submitting authorization requests to ensure compliance Requirements Proven experience in managed care or medical office settings with a strong understanding of insurance verification processes Familiarity with medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10, and ICD coding standards Knowledge of HIPAA regulations to ensure patient confidentiality and data security Prior experience in dental or medical office environments is highly desirable Strong organizational skills with the ability to manage multiple requests simultaneously under tight deadlines Excellent communication skills for liaising effectively with providers, insurers, and patients Office experience with proficiency in electronic health records (EHR) systems or similar software Join us in making a difference by ensuring patients receive the care they need without unnecessary delays. Your dedication will help improve healthcare accessibility while supporting our mission to deliver exceptional service through precision and compassion!