Job Details

Job Description:

Pay Range: $21.83hr - $26.83hr

Responsibilities:

• Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service.
• Create electronic folders for new patients.
• Organize patient medical records in preparation for prior authorization and appeals process.
• nswers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling.
• Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers.
• Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome.
• Communicates and builds relationships with HCP offices and Field Reimbursement Managers regarding all inquiries for the handling of cases, i.e., missing case information, benefits etc.
• Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases.
• Coordinates with lead and supervisor regarding complicated cases.
• Build Quality into all aspects of their work by maintaining compliance to all quality requirements.

• High School Diploma.
• Minimum 2-3 years of recent Insurance Pre-Authorization experience.
• Must have recent experience.
• Experience working with various payors including, Medicare, Medicaid, and Private Payor, as it relates to medical procedures, services, and devices.
• Experience building effective relationships with internal and external customers.