Medical Prior Authorization Specialist-REMOTE

Medical Prior Authorization Specialist

This position is responsible for a variety of functions related to healthcare coverage. It includes verification of medical coverage, along with notification, prior authorization, and/or pre-determination of healthcare benefits for proposed medical services, to ensure reimbursement for rendered care. This position routinely works with physicians, clinic support staff, case managers, nurses, insurance utilization management staff, and patients to initiate pre-authorization and resolve issues that arise during the prior authorizations process.

Performance Requirements: Knowledge, Skills and Abilities:

1. Knowledge of billing practices and clinic policies and procedures.

2. Knowledge of ICD-10 and CPT codes for clinic operating policies.

3. Demonstrated critical thinking and ability to analyze information and problem solve

4. Demonstrated knowledge of and ability to Verify Medical Insurance

5. Ability to manage multiple projects and deadlines to mitigate delays.

6. Ability to navigate and maneuver through multiple web sites.

7. Ability to understand and interpret policies and regulations.

8. Ability to read and interpret medical charts.

9. Ability to examine documents for accuracy and completeness.

10. Excellent computer, multi-tasking and phone skills, with ability to work under pressure

11. Ability to work independently within a team setting, and effectively communicates when working with others.

12. Ability to provide professional and courteous service in all interactions with internal and external customers

13. TEAM PLAYER, and willing to be diversified in job duties

On-Site Training is required & will take place in Burleson for 2-3weeks then employee will work remotely. Position is 9a-6p. OT required during peak season (October-December). Salary: DOE