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Prior Authorization

3 months ago

Mount Juliet, United States Center for Spine, Joint, Neuromusuclar Rehabilitation Full time
Job DescriptionJob DescriptionSalary:

Prior Authorization Coordinator

The Prior Authorization Coordinator we be primarily responsible for obtaining all types of prior authorizations. These prior authorizations will include medications, procedures, prescriptions, and testing. The position will require professional and courteous interaction with patients, pharmaceutical representatives, providers, pharmacies, and insurance carriers to accurately obtain the required information to process prior authorizations.

Essential Functions

  • Effective communication both in person and on the phone to establish/maintain cooperative relationships with patients, providers, pharmaceutical companies, and insurance representatives.
  • Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
  • Verify patient’s pharmacy insurance eligibility.
  • Effectively utilize the EMR and specialty pharmacy portals for medication programs
  • Accurately document all patient, pharmacy, and insurance carrier interactions in EMR.
  • Copy, fax and mail documents and information as requested by insurance carrier.
  • Schedule follow-up appointments and injections.

Competencies

  • Accuracy – Ability to perform work accurately and thoroughly.
  • Communication – Ability to communicate effectively verbally and in writing.
  • Computer Skills – Proficient ability to use a computer and electronic medical record.
  • Confidentiality – Maintain patient, team member and employer confidentiality. Comply with all HIPAA regulations.
  • Customer Service Oriented – Friendly, cheerful, and helpful to patients and others. Ability to meet patients and others needs while following office policies and procedures.
  • Detail Oriented – Ability to pay attention to the minute details of a project or task.
  • Flexibility – Ability to adapt easily to changing conditions and work responsibilities.
  • Multi-Task – Ability to handle more than one task at the same time.
  • Working Under Pressure – Ability to complete assigned tasks under stressful situations.


Work Environment

  • Environmentally controlled medical office environment.
  • Fast paced environment with occasional high-pressure situations.
  • Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public.

Scheduled: Monday – Thursday: 7:30am-4:30pm, Friday 7:30am – 12pm