What are the responsibilities and job description for the Prior Authorization Specialist position at Family Care Medical Group?
Overview
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. In this role, you will be responsible for ensuring that patients receive the necessary pre-approvals for medical services, procedures and medications. You will work closely with healthcare providers, nurses, insurance companies, and patients to facilitate the authorization process, ensuring compliance with managed care protocols.
Duties
- Review and process prior authorization requests for medical services and procedures.
- Communicate with healthcare providers to gather necessary documentation and information.
- Verify patient insurance coverage and eligibility through insurance verification processes.
- Utilize medical coding knowledge (ICD-10, ICD-9) to ensure accurate coding of diagnoses and procedures.
- Maintain organized medical records and documentation related to prior authorizations.
- Collaborate with managed care organizations to resolve any issues related to authorizations.
- Provide support to patients by explaining the authorization process and addressing any concerns.
- Stay updated on changes in insurance policies, coding requirements, and regulations affecting prior authorizations.
Experience
- Previous experience in a dental office or medical office setting is preferred.
- Familiarity with medical coding practices and terminology is essential.
- Knowledge of managed care processes and insurance verification is highly desirable.
- Experience handling medical records and understanding of healthcare compliance standards.
- Proficiency in using office software and electronic health record systems.
If you are passionate about facilitating patient care through effective authorization processes and possess the required skills, we encourage you to apply for this vital role in our organization.
Job Types: Full-time, Part-time
Pay: $17.00 - $22.50 per hour
Expected hours: 24 – 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
Salary : $17 - $23
