Prior Authorization Specialist

Qualifications:

• Bachelor's degree in any allied medical course
• At least 6 months of experience in prior authorization
• Strong communication skills, both verbal and written
• Willing to work onsite

Job Description:

• Contacting insurance companies to request prior authorization for specific medical procedures or prescriptions.
• Verifying Information: Checking patient eligibility, benefits, and coverage with insurance companies.
• Documenting Interactions: Keeping detailed records of all communications with insurance companies and patients.
• Managing Denials: Investigating denials, resubmitting requests, and potentially appealing decisions to ensure patient access to necessary care.
• Communicating with Patients: Explaining the prior authorization process to patients, including potential delays and financial implications.
• Collaborating with Providers: Working closely with healthcare providers to collect necessary clinical information for authorization requests.