Prior Authorization Specialist - Ophthalmology

Description

 Are you a caring and enthusiastic person looking for a fulfilling healthcare career? Pepose Vision Institute is a fun, fast-paced, lively surgeon's office. We work hard to ensure our patients have the latest treatment options. Our commitment is to provide the highest quality of comprehensive eye care! We are seeking a Prior Authorization Specialist to join our great team! 

The Prior Authorization Specialist role follows prescribed policies and procedures, performs a variety of verification tasks using standard healthcare guidelines. Obtains insurance coverage information from patient, and payor, utilizing all available tools, including medical documentation, and contract information to select the appropriate insurance policy/plan. Obtaining accurate benefit information to identify patient financial liability.

What we Offer:

• Competitive market compensation 
• Medical, Dental & Vision Insurance
• 401K matching
• Life Insurance
• Generous PTO and paid company holidays
• Career ladders and growth opportunities

Duties include:

• Verify in- and out-of-network insurance benefits via phone calls to insurance companies and checking insurance company online portals.
• Assisting patients with high-cost Retina medication authorizations.
• Update patient accounts with accurate insurance information.
• Communicate with patients regarding their insurance coverage and any out-of-pocket expenses.
• Work closely with medical billing team to ensure claims are processed correctly.
• Maintain patient confidentiality and comply with all HIPAA regulations.
• Utilize medical billing and coding knowledge to accurately verify insurance information.
• Approve or decline orders based on the insurance benefits and threshold limits
• Mark the status of orders in spreadsheets
• Follow up on patient balances.

Position Requirements:

• Understanding copay Assistance for retina medications 
• An understanding of insurance eligibility and benefits investigations
• The ability to answer billing questions 
• 1+ years of medical revenue cycle management
• 2+ years in a medical office setting with medical benefits verification & prior authorization experience preferred
• Prior ophthalmology experience preferred
• Strong attention to detail and accuracy in verifying insurance information.
• Ability to work at a fast pace with minimal supervision
• Familiarity with managed care plans and insurance procedures.

If you are seeking new adventures in patient care and have a passion for going above and beyond to ensure all our patients are given the best patient experience, then we want to hear from you... Please Apply!

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