What are the responsibilities and job description for the Pre-Authorization Specialist position at Pure Infusion Suites?
Position Summary:
As pre-authorization representative at Memory Treatment Centers you are responsible for the successful completion of prior authorizations for any clinical procedures ordered by our providers. This process requires high levels of organization, dedication, and persistence. The position serves as an advocate for patients and aggressively fights on behalf of patients to receive access to needed clinical testing/procedures ordered by our providers.
Key Responsibilities
- Comfortable working daily with insurance payers to gain prior authorization approval for clinical procedures/test ordered from our providers.
- Comfortable working and communicating with remote teams in multiple states to coordinate the items needed by insurance to obtain prior authorization and ensure the clinics are not seeing patients before authorization is obtained.
- Understands the responses given from insurance companies when submitting prior authorizations.
- Ensures eligibility and benefits are properly verified and correct insurance has been loaded into EHR system.
- Exhibits excellent customer service skills and serves as an advocate for the patient with insurance companies.
- Complies with departmental organizational policies and procedures and adheres to external agency requirements.
- Performs other related duties as assigned or requested to maintain a high level of service.
Benefits
- Competitive health, dental and vision
- Competitive Pay (We strive to be generous in our pay for skills you already have)
- Over 22 paid days off a year
- 1 community service paid day off a year to do a service project of your choice.
- 401k with a 4% match
Required Knowledge and Skills
- Demonstrated work history of being successful at handling prior authorizations, appeals and denials.
- Demonstrates clear communication and effective collaboration to optimize patient care and clinic operations.
- Excellent customer service skills
- Ability to collaborate with others and offer outstanding customer service.
- Demonstrates a high degree of computer literacy in a PC environment.
- Strong organizational, interpersonal and communication skills.
- Six months of experience of successfully completing prior authorizations for clinical procedures/ test with insurance companies
Education/Licensure/Technical Requirements.
- High school Diploma or equivalent required.
- Some college or business school training preferred.
- Six months of experience with prior authorizations, federal and commercial required.
- Ability to meet U.S. employment and eligibility requirements.
