What are the responsibilities and job description for the Home Health Prior Authorization Specialist position at Comprehensive Medical Home Care?
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 and treatments by obtaining prior authorizations from insurance providers. The ideal candidate will possess a strong understanding of medical terminology, coding, and managed care processes, along with excellent organizational skills to manage multiple requests efficiently.
Duties
- Review and process prior authorization requests for Clinical Services delivered to patients.
- Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
- Verify patient eligibility and benefits through insurance verification processes.
- Utilize knowledge of ICD-10 coding and medical records to support authorization requests.
- Maintain compliance with HIPAA regulations to ensure patient confidentiality.
- Document all interactions and maintain accurate records of authorization requests and outcomes.
- Collaborate with medical office staff to streamline the authorization process.
- Follow-up and Follow-through on Insurance Denials and Appeals.
- Stay updated on changes in managed care policies and procedures that may affect authorization requirements.
Qualifications
- Proven experience in a medical office setting preferred.
- Strong understanding of medical terminology and coding practices, including ICD-10.
- Familiarity with managed care systems and insurance verification processes.
- Excellent organizational skills with the ability to manage multiple tasks simultaneously.
- Strong communication skills, both verbal and written, for effective interaction with healthcare professionals and patients.
- Ability to work independently as well as part of a team in a fast-paced environment.
- Proficiency in using office software applications for documentation and record keeping.
If you are passionate about supporting patient care through effective authorization processes and meet the qualifications outlined above, we encourage you to apply for this vital role within our organization.
Job Type: Full-time
Benefits:
- Dental insurance
- Disability insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- Home Health Prior Authorization: 1 year (Required)
Work Location: In person