What are the responsibilities and job description for the Prior Authorization Specialist position at Advocare Pulmonary and Sleep Specialists?
THIS POSITION HAS NO NIGHTS, NO WEEKENDS, AND NO HOLIDAYS
This postion may be between our West Chester and King of Prussia offices
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. This role is crucial in ensuring that patients receive the necessary medical services and treatments by managing the prior authorization process with insurance companies. The ideal candidate will have a strong background in medical office operations, and insurance verification, along with a commitment to maintaining compliance with HIPAA regulations.
Duties
- Review and process prior authorization requests for medical procedures, tests, and medications.
- Communicate effectively with healthcare providers, patients, and insurance companies to gather necessary information.
- Verify patient insurance coverage and eligibility for services.
- Maintain accurate and organized medical records in compliance with HIPAA standards.
- Collaborate with managed care organizations to facilitate timely approvals and resolve any issues that arise during the authorization process.
- Provide support to medical staff regarding authorization requirements and updates on patient status.
- Stay informed about changes in insurance policies, regulations, and managed care practices.
Requirements
- Previous experience in a medical office setting.
- Proficient in insurance verification processes and managed care protocols.
- Familiarity with handling medical records while adhering to HIPAA regulations.
- Excellent communication skills, both verbal and written.
- Strong organizational skills with attention to detail to manage multiple requests efficiently.
- Ability to work independently as well as part of a team in a fast-paced environment.
- Proficiency in office software applications for documentation and reporting purposes.
- Follow up on pending authorizations to ensure timely response from insurance companies.
- Provide support in resolving any issues related to prior authorization denials or appeals.
- Communicate with healthcare providers to obtain necessary documentation for authorizations.
If you are reliable, dependable, have an excellent work ethic, work well independently or in a team environment, can be at work at 6:45 AM, then please send us your resume.
Job Type: Full-time
Expected hours: 36 – 40 per week
Benefits:
- 401(k)
- Paid time off
Application Question(s):
- Adovcare, LLC requires all employees to have a background check and a drug screening.
Are you willing to have these done?
Education:
- High school or equivalent (Required)
Experience:
- Prior Authorization: 1 year (Required)
Language:
- English (Required)
Work Location: In person
