What are the responsibilities and job description for the Prior Authorization Coordinator position at Claros Solutions LLC?
Job Overview
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. This role is essential in ensuring that patients receive the necessary medical services by managing the prior authorization process with insurance companies. The ideal candidate will have a strong understanding of medical terminology, coding, and insurance verification processes, as well as a commitment to maintaining compliance with HIPAA regulations.
Duties
- Review and process prior authorization requests for medical procedures and services.
- Communicate effectively with healthcare providers, insurance companies, and patients to gather necessary information.
- Verify patient eligibility and benefits for services requested.
- Utilize ICD-9 and ICD-10 coding systems to ensure accurate documentation.
- Maintain organized medical records and documentation in compliance with HIPAA standards.
- Collaborate with medical office staff to streamline the authorization process.
- Follow up on pending authorizations and resolve any issues that may arise.
- Stay updated on changes in insurance policies, medical coding, and regulations affecting prior authorizations.
- Assist with support in other areas of the RCM team
Qualifications
- Experience in a medical office setting is preferred.
- Proficiency in medical terminology and understanding of medical records management.
- Familiarity with insurance verification processes and procedures.
- Knowledge of and ICD-10 coding systems is essential.
- Strong attention to detail with excellent organizational skills.
- Ability to work independently as well as part of a team in a fast-paced environment.
- Understanding of HIPAA regulations related to patient information confidentiality.
- Previous experience in prior authorization or related roles is a plus.
Job Type: Full-time
Pay: $18.00 - $20.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $18 - $20