Medication Prior Authorization Specialist

Job Summary
The Prior Authorization Specialist plays a crucial role in the healthcare system by ensuring that patients receive necessary medical services and treatments in a timely manner. This position involves verifying insurance coverage, obtaining prior authorizations, and ensuring compliance with HIPAA regulations. The ideal candidate will have a strong understanding of medical records, as well as experience in a medical office setting.

Responsibilities

• Conduct insurance verification to confirm patient eligibility for services.
• Obtain prior authorizations from insurance companies for various medications for chronic conditions.
• Collaborate with healthcare providers and clinical staff to gather necessary documentation for authorization requests.
• Maintain accurate and up-to-date medical records in compliance with HIPAA regulations.
• Communicate effectively with patients regarding their insurance coverage and authorization status.
• Process requests efficiently while adhering to managed care guidelines.
• Stay informed about changes in insurance policies, coding systems (ICD-9, ICD-10), and healthcare regulations.
• Assist in resolving any issues related to denied authorizations or appeals.

Skills

• Proficient in insurance verification processes and procedures.
• Experience working in a medical office environment is preferred.
• Strong knowledge of HIPAA regulations and patient confidentiality practices.
• Familiarity with medical records management and documentation standards.
• Understanding of insurance carrier requirement for medical prior authorizations including clinical guidelines.
• Excellent organizational skills with attention to detail to manage multiple tasks effectively.
• Strong communication skills, both verbal and written, to interact with patients and healthcare professionals.
• Ability to work collaboratively within a team while also being self-motivated to complete tasks independently.

This role is essential for facilitating patient care through effective communication and coordination between patients, providers, and insurance companies. If you are passionate about helping others navigate the complexities of healthcare authorization processes, we encourage you to apply for this rewarding position as a Prior Authorization Specialist.

Job Type: Full-time

Pay: $19.00 - $20.17 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Ability to Relocate:

• Akron, OH 44333: Relocate before starting work (Required)

Work Location: Hybrid remote in Akron, OH 44333

Salary : $19 - $20