Prior Authorization Coordinator - Non-Exempt

Description

Job title: Insurance Prior Authorization Specialist

Location: Charlotte, North Carolina - ECPC Charlotte Integrative Pain and Spine Institute

Status: Full-time, Non-Exempt

Department: ECPC Charlotte Integrative Pain and Spine Institute - Administrative

Reports to:Practice Manager, ECPC Charlotte Integrative Pain and Spine Institute

Job Supervisory Responsibilities:None

Schedule: Monday - Thursday 7:30am - 4:00 pm; Fridays: 7:30am - 12pm

Job Summary

The Insurance Authorization Specialist is responsible for conducting prior authorizations for medication, imaging and in-office and outpatient procedures (such as MRIs and other procedures that require prior authorizations), insurance verifications, and has extensive knowledge of medical programs to include Medicare and Medicaid. The ideal candidate will be great with computers, is comfortable speaking over the phone, and is an effective multi-tasker handling many different tasks on a daily basis.

The Insurance Authorization Specialist will be the subject matter expert in prior authorizations, but also function as a back-up to other roles in the clinic. The incumbent may at times be the back-up front desk receptionist if someone is on vacation or out, or answer patient inquiries regarding benefits and procedures.

Duties/Responsibilities

• Obtain, review, and request prior authorizations for various medication, imaging and other outpatient procedures related to pain procedures and MRIs.
• Familiar with the appeals and denials process with insurance companies.
• Verify insurance with health insurance agencies to include Medicare and Medicaid.
• Utilize Electronic Medical Record System to obtain or document patient insurance information.
• Enter patient information accurately and per guidelines so patients can get scheduled for procedures or visits.
• Answers all incoming calls professionally and with a courteous and friendly attitude; assesses callers needs and responds in a timely manner.
• Checks patients in for their visit, and obtains necessary insurance and contact information.
• May serve as a back-up front desk receptionist during peak hours or during a colleagues vacation.
• Perform an array of other duties such as setting up or tearing down rooms, answering the phone, or helping patients with questions regarding their bill.
• Performs other duties as assigned.
  
  

Education And Experience

• High school diploma required.
• Minimum of two years’ experience in a medical office working prior authorizations and insurance verifications.
• Experience in pain management is highly desirable.
• Two years’ experience with EMR systems.
• Knowledge of medical terminology and insurance plans.
  
  

Required Skills/Abilities

• Must be confident and detail-oriented.
• Must possess a professional attitude and telephone courtesy.
• Ability to prioritize and multitask in a fast paced and changing environment.
• Must be self-motivated and take initiative.
• Due to the quick nature of procedures, incumbents must be highly reliable and dependable.
  
  

Work Environment/Physical Requirements

• Work performed in an office environment.
• Involves frequent contact with physicians, leadership, and medical office staff.
• Work may be stressful at times.
• Interaction with others is frequent and often disruptive.
  
  

ECAA is an equal opportunity employer and does not discriminate against any applicant or employee on the basis of age, race, color, religion, sex, national origin, genetic information, disability, or other legally protected status. This policy extends to all terms, conditions, and privileges of employment, as well as the use of the Company's facilities and participation in all activities sponsored by the Company.