Medical Prior Authorization Specialist

Prior Authorization Specialist Job Summary

Assists with the front desk responsibilities of the podiatry practice. 

Essential Functions (May perform part or all of the following)

• Verifies insurance eligibility, authorization, and demographics of current and new patients in an accurate and timely manner


• Communicates payer authorization and eligibility information


• Enters insurance authorization and eligibility information


• Notifies management regarding lack of payer coverage or other service non- coverage issues


• Performs re-authorization and eligibility checks in a timely manner


• Communicates and documents information regarding change in authorization and eligibility


• Monitor and ensure all patient authorization of services are current and quantity and type of services provided meet payer requirements


• Reviews and ensures appropriate processing of authorizations


• Answers phones.


• Demonstrates working knowledge of E.M.R. system.


• Adhoc duties and responsibilities 

Education, Experience and Certifications
High School Diploma or GED required. Computer experience required. Customer Service experience required. Understanding of medical insurance required. Experience with Medical Records Software and practice management software preferred. Front desk medical practice experience required. Must have a working understanding of OSHA & HIPAA compliance.

Physical Requirements
Must be able to sit for long periods of time and work in a fast-paced office environment. Should be able to bend and lift up to 10 lbs.

Reports to: Office Manager and/or Physicians

Location

Jacksonville, NC

Employment Type

Full-Time