What are the responsibilities and job description for the Prior Authorization Specialist position at Vital Care of Oklahoma City?
Job Summary
The Prior Authorization Specialist plays a crucial role in the healthcare system by ensuring that patients receive necessary medical services and treatments through effective communication with healthcare providers and insurance companies. This position requires a strong understanding of medical terminology, coding, and insurance authorization processes including completion and management of major medical and pharmacy benefit authorizations. The ideal candidate will be detail-oriented, possess excellent organizational skills, and have a commitment to maintaining compliance with HIPAA regulations.
Duties
- Review and process prior authorization requests for infusion medications, medical services and procedures.
- Communicate with healthcare providers to gather necessary documentation and information.
- Utilize medical coding knowledge, including ICD-9, to ensure accurate submission of claims.
- Maintain accurate records of all prior authorization requests and outcomes in compliance with HIPAA standards.
- Collaborate with physician offices and managed care organizations to facilitate and manage the authorization process.
- Stay updated on changes in insurance policies, medical terminology, and coding practices.
Requirements
- Proficient knowledge of medical terminology and coding practices.
- Experience in an office environment, within a healthcare setting, preferably specialty or home infusion.
- Familiarity with medical records management and HIPAA regulations.
- Strong skills in insurance authorization processes and managed care systems.
- Ability to work independently as well as part of a team.
- Excellent communication skills, both written and verbal, to interact effectively with patients, providers, and insurers.
- Detail-oriented with strong organizational skills to manage multiple tasks efficiently.
This position is essential for ensuring that patients receive timely access to necessary healthcare services while adhering to regulatory standards. If you are passionate about contributing to patient care through administrative support in the healthcare field, we encourage you to apply for this rewarding opportunity.
Job Type: Full-time
Pay: $23.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- Disability insurance
- Health savings account
Education:
- High school or equivalent (Required)
Experience:
- prior authorization: 1 year (Required)
- Microsoft Office: 1 year (Required)
Work Location: In person
Salary : $23 - $25