What are the responsibilities and job description for the Pre-Authorization Specialist/ Medical Assistant position at IRWIN COUNTY HOSPITAL?
Job Summary
The Prior Authorization Specialist plays a crucial role in the healthcare system by ensuring that patients receive the necessary medical services and treatments as authorized by their insurance providers. This position involves reviewing and processing prior authorization requests, verifying patient eligibility, and ensuring compliance with insurance guidelines. The ideal candidate will possess a strong understanding of medical terminology and coding, as well as experience in a medical office setting.
Duties
- Review and process prior authorization requests for medical services and procedures.
- Verify patient eligibility and benefits with insurance providers.
- Communicate effectively with healthcare providers, patients, and insurance companies to gather necessary information.
- Maintain accurate records of prior authorization requests and outcomes in compliance with HIPAA regulations.
- Utilize knowledge of ICD-9 and ICD-10 coding to ensure proper documentation is submitted for authorizations.
- Collaborate with clinical staff to ensure that all required documentation is complete and accurate.
- Stay updated on changes in managed care policies and procedures affecting prior authorizations.
Skills
- Proficient understanding of medical terminology, coding, and billing processes.
- Experience working in a dental office or medical office environment is preferred.
- Familiarity with ICD-9 and ICD-10 coding systems.
- Knowledge of managed care practices and prior authorization processes.
- Strong organizational skills with attention to detail to manage multiple requests efficiently.
- Excellent communication skills, both verbal and written, to interact with various stakeholders.
- Ability to maintain confidentiality and adhere to HIPAA regulations regarding patient information.
Job Type: Full-time
Pay: $12.00 - $17.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $12 - $17