What are the responsibilities and job description for the Prior Authorization Specialist position at Soni?
A well established Medical Office is seeking a detail-oriented Prior Authorization Specialist to join their healthcare team! In this role, you will play a vital part in ensuring timely and accurate insurance authorizations for patient services. You will work collaboratively with medical providers and insurance carriers to facilitate efficient care delivery.
Responsibilities:
Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.
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Responsibilities:
- Obtain and verify patient insurance benefit coverage using insurance websites or by contacting carriers.
- Request, track, and obtain pre-authorizations for medical services within designated timeframes.
- Process referrals and submit medical records to expedite authorizations.
- Demonstrate knowledge of medical terminology and office procedures, including HIPAA regulations.
- Communicate insurance changes or trends within the team.
- Maintain productivity standards for the department.
- Document all communications and contacts with providers and personnel in standardized formats.
- Review the accuracy and completeness of requested information and ensure supporting documents are present.
- Review denials and follow up with providers to obtain necessary information for appeals.
- Prioritize incoming authorizations based on urgency.
- Communicate with medical providers and staff about patient concerns or issues related to verification.
- High School Diploma or equivalent.
- Two years of experience in a healthcare environment.
- Knowledge of Out-of-Network providers is highly preferred.
- Experience with insurance authorizations is preferred.
- Excellent verbal and written communication skills.
- Strong organizational and business office skills.
- Goal-oriented and detail-oriented with the ability to work in a fast-paced environment.
- Knowledge of medical terminology.
- Ability to build and maintain relationships with insurance representatives.
- Ability to work effectively with physicians and other medical staff.
- Commitment to maintaining patient and company confidentiality.
Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.
#SONICNJ
Salary : $21 - $25
