Demo

Prior Authorization Specialist

The Pain Treatment Institute
Mc Kinney, TX Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 3/22/2025

The Authorization and Benefits Specialist is responsible for obtaining benefits and preauthorization from payors, following up on authorization requests, obtaining retroactive authorizations, and maintaining authorizations for all procedures, DME, LOP, Personal injury and workers comp.

JOB-SPECIFIC FUNCTIONS:

- Responsibilities include initiating, following up, and securing benefits and authorizations sent to third-party payors. Obtain authorization renewals

-Track and follow up on all pending authorizations at days depending upon payer guidelines to expedite the claims process and avoid lost revenue

-Process authorizations electronically, utilizing payer portals, fax, or telephone working with the payers to secure authorizations retrospectively and/or requesting single case agreements for out of network patients

-Work directly with providers to secure clinical notes and other supporting documentation required to obtain authorizations timely

-Verify authorization quantities and effective dates are returned and processed correctlyby the third-party payers, and loaded correctly in all systems

-Create and maintain centralized payer master list to record requirements by payer

-Create a payer authorization manual and tips to securing authorization

- Identify opportunities to improve authorization efficiencies electronically

- Review and interpret insurance group pre-certification requirements, ensuring that proper pre-authorizations have been obtained from the payer and documented.

- Interact with patients and third-party insurance companies to secure retroactive insurance coverage and authorizations, and/or single case agreements for out of network patients

Qualifications

-Education: High School Diploma or GED required; some college preferred.

-Experience: A minimum of 2 years in benefit verification and authorizations required. Pain management experience preferred.

-Skills: Communicates clearly and concisely, verbally and in writing, establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

- LOP and PI experience

-Ability to sustain prolonged sitting and extended computer use. Requires working under some stressful conditions to meet deadlines and to make quick decisions.

-Require hand-eye coordination and manual dexterity.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Life insurance
  • Vision insurance

Work Location: In person

Salary : $18 - $20

If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

What is the career path for a Prior Authorization Specialist?

Sign up to receive alerts about other jobs on the Prior Authorization Specialist career path by checking the boxes next to the positions that interest you.
Income Estimation: 
$41,365 - $50,783
Income Estimation: 
$55,044 - $66,097
Income Estimation: 
$41,365 - $50,783
Income Estimation: 
$55,044 - $66,097
Income Estimation: 
$74,062 - $95,293
Income Estimation: 
$111,858 - $155,666
Income Estimation: 
$55,044 - $66,097
Income Estimation: 
$55,153 - $70,123
Income Estimation: 
$37,598 - $46,086
Income Estimation: 
$41,365 - $50,783
Income Estimation: 
$39,690 - $49,584

Sign up to receive alerts about other jobs with skills like those required for the Prior Authorization Specialist.

Click the checkbox next to the jobs that you are interested in.

  • Customer Support Skill

    • Income Estimation: $48,040 - $64,138
    • Income Estimation: $52,097 - $69,801
  • Document Processing Skill

    • Income Estimation: $45,079 - $58,782
    • Income Estimation: $46,208 - $58,785
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Job openings at The Pain Treatment Institute

The Pain Treatment Institute
Hired Organization Address Mc Kinney, TX Full Time
The Pain Treatment institute is a busy and growing interventional pain management practice with multiple locations. We a...
The Pain Treatment Institute
Hired Organization Address Mesquite, TX Full Time
The Pain Treatment institute is a busy and growing interventional pain management practice with multiple locations. We a...

Not the job you're looking for? Here are some other Prior Authorization Specialist jobs in the Mc Kinney, TX area that may be a better fit.

Precertification Specialist - Prior Authorization

Spine Team Texas Management Company, Grapevine, TX

AI Assistant is available now!

Feel free to start your new journey!