Prior Authorization Specialist

Description:

Verifies insurance eligibility and benefits of prospects/referrals and determines rate requirements as it relates to in or out of network coverage on a daily basis in an accurate and timely manner.

-Communicates patient benefits in a timely manner using the appropriate legacy system and associated software application as found in patient notes, tasks, workflow, email, etc.

Documents and forwards patient deductible, out-of-pocket expense, life time maximum, home health or hospice days and patient responsibility to the agency.

Reviews and replies to branch locations urgent requests

Obtains all authorization needed from payer for services ordered or requested

Documents specific details related to the authorization including effective and end dates

Serves as a liaison between the branch location and the payer on a regular basis.

Manages work assignment to ensure all tasks and coordination notes are completed.

Additional Skills & Qualifications:Candidates MUST be available to work from 8:00am - 5pm daily. They must also have the flexibility to work a 10am - 6:30pm schedule 1-2 days per week depending on staffing. The month of January is a BLACKOUT month - no time off requests will be accepted. Please make sure candidates are aware of this.Any time-off within the first 90-days of work MUST be approved prior to submission. High school diploma required Former revenue cycle experience is preferred; not required EPIC experience is preferred; not required (translates well to their HomeCare/ HomeBase system)Excellent oral and written communication skills Excellent organizational and analytical skills Must be a independent and critical thinkerAbout TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.