What are the responsibilities and job description for the Prior Authorization Specialist position at Professional Imaging?
Job Title: Prior Authorization Specialist
Location: Professional Imaging
1050 Old Des Peres Rd, STE 30
St. Louis, MO 63131
Position Overview:
The Pre-Authorization Specialist is responsible for obtaining and securing prior authorizations for diagnostic imaging procedures. This role ensures that all necessary approvals are acquired before services are rendered to optimize insurance reimbursement and minimize patient out-of-pocket expenses. The specialist will work closely with patients, insurance companies, and healthcare providers to ensure a smooth and efficient authorization process.
Key Responsibilities:
-Obtain Pre-Authorizations: Contact insurance companies to obtain prior authorizations for diagnostic imaging procedures, including MRI, CT, ultrasound, and X-ray.
-Verify Insurance Information: Accurately verify patient insurance information and eligibility before proceeding with authorization requests.
- Documentation: Maintain detailed and accurate records of all authorization requests, approvals, and denials. Update patient files with authorization status and relevant details.
- Communication: Provide clear and concise communication with patients, healthcare providers, and insurance companies. Inform patients of their authorization status and any potential delays or issues.
- Follow-Up: Proactively follow up with insurance companies to ensure timely receipt of authorizations. Address any issues or obstacles that may arise during the authorization process.
- Compliance: Ensure all authorization requests comply with insurance guidelines and facility policies.
- Customer Service: Provide excellent customer service by addressing patient inquiries and concerns regarding insurance and authorization processes.
- Collaboration: Work closely with the billing department to ensure all necessary information is provided for accurate and timely claim submissions.
Qualifications:
- Education: High school diploma or equivalent; some college coursework in healthcare administration or a related field is preferred.
- Experience: Previous experience in a healthcare setting, particularly in insurance verification or authorization, is highly desirable.
- Skills: Strong communication and interpersonal skills, attention to detail, ability to work in a fast-paced environment, proficiency with computer systems and healthcare databases.
- Knowledge: Understanding of insurance policies, medical terminology, and diagnostic imaging procedures.
Working Conditions:
- Environment: Office setting within a diagnostic imaging facility.
- Hours: Full-time position with standard office hours. Occasional overtime may be required.
Monday - Friday 8am-4:30pm
Job Type: Full-time
Pay: $18.00 - $23.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Paid time off
- Vision insurance
Experience:
- Insurance verification: 2 years (Required)
- Medical billing: 1 year (Preferred)
Ability to Relocate:
- St. Louis, MO 63131: Relocate before starting work (Required)
Work Location: In person
Salary : $18 - $23