What are the responsibilities and job description for the Prior Authorization Specialist position at United Drugs?
Job Summary
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. This role is essential in ensuring that patients receive the necessary medical services and treatments by obtaining prior authorizations from insurance companies. The ideal candidate will have a solid understanding of medical terminology, coding, and the healthcare authorization process, along with a commitment to maintaining compliance with HIPAA regulations.
Responsibilities
- Review and process prior authorization requests for medical procedures and treatments.
- Communicate effectively with healthcare providers, insurance companies, and patients to gather necessary information.
- Utilize coding systems such as ICD-10 and ICD-9 to ensure accurate documentation and billing.
- Maintain detailed records of authorization requests and outcomes in compliance with medical office protocols.
- Ensure adherence to HIPAA regulations while handling sensitive patient information.
- Collaborate with medical staff to clarify any discrepancies or additional information needed for authorization.
- Stay updated on changes in insurance policies, coding guidelines, and healthcare regulations that may affect the authorization process.
Qualifications
- Previous experience in a medical office or dental office setting is preferred.
- Strong knowledge of medical terminology and coding practices, including ICD-10 and ICD-9.
- Familiarity with medical records management and office procedures.
- Excellent communication skills, both verbal and written, to interact effectively with various stakeholders.
- Ability to work independently while managing multiple tasks efficiently.
- Detail-oriented with strong organizational skills to maintain accurate records.
- Understanding of HIPAA regulations regarding patient confidentiality and data protection.
Join our team as a Prior Authorization Specialist where you can make a meaningful impact on patient care by facilitating access to necessary medical services.
Job Types: Full-time, Part-time
Pay: $20.52 - $21.51 per hour
Expected hours: 25 per week
Work Location: Hybrid remote in Newark, NJ 07107
Salary : $21 - $22