A Registrar or Patient Service Representative provides direct assistance to patients at a health care or long term care facility. Answers questions and helps resolve complaints; provides liaison with health care providers; may assist with coordinating appointments or addressing billing or insurance issues.
TBD Job Summary We are seeking a dependable and detail-oriented Prior Authorization Representative to join our team. This position is responsible for obtaining and tracking prior authorizations for medications, procedures, services, and/or diagnostic testing. The ideal candidate communicates professionally, stays organized in a fast-paced environment, and understands the importance of accuracy, confidentiality, and timely follow-up. Responsibilities Submit prior authorization requests to insurance companies and payer portals. Verify patient insurance eligibility, benefits, and authorization requirements. Gather required clinical documentation from providers and medical records. Track pending requests and follow up with insurance companies until a decision is received. Communicate authorization decisions, delays, and additional requirements to patients, providers, pharmacies, and internal staff. Assist with denied authorizations, appeals, peer-to-peer requests, and resubmissions. Document all authorization activity accurately in the electronic health record or practice-management system. Maintain organized records and meet required deadlines. Follow HIPAA requirements and protect confidential patient information. Work closely with clinical, scheduling, billing, and administrative teams. Assist with Spravato clinic. Perform other related duties as assigned. Qualifications High school diploma or equivalent required; associate degree or relevant certification preferred. One or more years of prior authorization, insurance verification, medical billing, pharmacy, or healthcare administrative experience preferred. Familiarity with commercial insurance, Medicare, and Medicaid requirements. Experience taking manual blood pressure. Experience using electronic health records and insurance payer portals. Knowledge of medical terminology, CPT, ICD-10, and HCPCS codes is preferred. Strong written and verbal communication skills. Excellent attention to detail, organization, and follow-through. Ability to manage multiple cases and priorities with minimal supervision. Professional and compassionate approach when communicating with patients and healthcare professionals. What We Offer Competitive compensation Medical, dental, and vision insurance Paid time off and paid holidays Supportive and collaborative work environment How to Apply Please submit your résumé through Indeed. Qualified applicants will be contacted to discuss the position and next steps.
Pay:
From $15.00 per hour Expected hours: 40.0 per week
Benefits:
Health insurance Prescription drug insurance Vision insurance Application Question(s): Do you have prior authorization experience?
