Prior Authorization Specialist

Prior Authorization Specialist

TEXAS PAIN INSTITUTE - 2.7

Fort Worth, TX Job Details Full-time From $20 an hour 19 hours ago Benefits Health insurance Dental insurance Paid time off Retirement plan Qualifications Medical office experience HIPAA Medical coding guidelines Medical records Attention to detail Patient interaction Typing Medical terminology Full Job Description Job Summary We are seeking a motivated and detail-oriented Prior Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing the prior authorization process to ensure timely approval of medical services and procedures. Your expertise will help facilitate seamless communication between healthcare providers, insurance companies, and patients, ensuring compliance with all relevant policies and confidentiality standards. This position offers an exciting opportunity to contribute to patient care coordination while maintaining accuracy and efficiency in a fast-paced environment. Responsibilities Review and process prior authorization requests for medical procedures and treatments using electronic health records (EHR) systems. Verify insurance coverage and eligibility by conducting insurance verification procedures in accordance with health insurance policies. Communicate effectively with healthcare providers to gather necessary documentation and clarify authorization requirements. Ensure compliance with HIPAA regulations and clinical confidentiality policies when handling sensitive medical records and patient information. Apply medical coding knowledge, including CPT and ICD-10 to accurately document services for authorization purposes. Collaborate with managed care organizations and insurance portals to facilitate approval processes and resolve any discrepancies or denials promptly. Maintain detailed records of all authorization requests, approvals, denials, and related correspondence within the electronic health records (EHR) system. Appeal denials promptly Update office staff when they are able to schedule patients after approvals for previously denied procedures are obtained. Qualifications Prior experience working in a medical office or healthcare setting is highly preferred. Strong knowledge of health insurance policies, managed care processes, and insurance verification procedures. Knowledge of insurance portals Familiarity with medical terminology and electronic health records (EHR/EHR) systems. Experience with medical coding such as CPT and ICD-10 is essential for accurate documentation. Understanding of HIPAA regulations to ensure patient privacy and data security at all times. Excellent communication skills to liaise effectively with healthcare providers, insurance representatives, and patients. Ability to manage multiple priorities efficiently in a dynamic environment; dental office experience is a plus but not required. Minimum 45 WPM when typing Bilingual is a plus Join our team as a Prior Authorization Specialist if you are passionate about streamlining healthcare processes while upholding the highest standards of confidentiality and accuracy. Your dedication will directly impact patient care delivery by ensuring timely approvals and clear communication across all parties involved!

Pay:

From $20.00 per hour

Benefits:

Dental insurance Health insurance Paid time off Retirement plan

Work Location:

In person