Prior Authorization Representative

Job Description

Prior Authorization Representative Job Description

Client Profile- An Indiana based Independent Physician-Owned radiology practices founded in 1967.

Job Summary- Prior Authorization Representative is responsible for securing inpatient / outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorizations before service are rendered. Must be comfortable working with clinical professionals.

Job Duties

• Verify insurance eligibility, benefits, network status and create pre-service liability estimate.
• Ensure accurate ICD, CPT codes and related medical records are submitted in the authorization request.
• Secure prior authorizations of inpatient and outpatient imaging.
• Acts as a liaison between the payer and clinic schedulers / medical support.
• Follows up on delayed or denied authorizations requests and escalates for resolution.
• Create detail documentation and maintain / stores the authorization paper trail.

Requirements

Qualifications

Salary : $20 - $21