What are the responsibilities and job description for the Prior Authorization Specialist position at Delray Center for Healing?
Job Overview
Delray Center for Healing is 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 medications, services and treatments by obtaining prior authorizations from insurance providers. The ideal candidate will have a strong background in medical office procedures and insurance verification, along with a solid understanding of medical terminology and HIPAA regulations.
Responsibilities
- Review and process prior authorization requests for medications, services and treatments.
- Verify patient insurance coverage and eligibility for medications and/or requested services.
- Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
- Maintain accurate records of all prior authorization requests and outcomes in compliance with HIPAA regulations.
- Collaborate with medical staff to ensure timely submission of authorization requests.
- Stay updated on changes in managed care policies and procedures affecting prior authorizations.
- Assist in resolving any issues or denials related to prior authorization requests.
Requirements
- Previous experience in a medical office setting is preferred.
- Excellent organizational skills with attention to detail.
- Ability to communicate effectively with healthcare professionals and patients.
- Proficient in using office software and electronic health record (EHR) systems.
- Knowledge of HIPAA regulations and commitment to maintaining patient confidentiality.
- Ability to work independently as well as part of a team.
- Knowledge and experience of working with specialty pharmacies is preferred.
- Experience submitting authorizations is preferred.
Job Type: Full-time
Pay: $18.00 - $20.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Paid time off
- Vision insurance
Experience:
- Insurance verification: 1 year (Preferred)
- prior authorization: 1 year (Preferred)
Work Location: In person
Salary : $18 - $20