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Pre-Authorization Specialist

4 months ago

Woodland Park, United States Coda Staffing Full time
Job DescriptionJob Description

Very busy Gastro practice – need to have an element of speed to keep up with the eligibility and authorization requests

This position is on site in Woodland Park NJ Mon thru Fri

  • Obtain pre-authorizations for gastro procedures (colonoscopy, endoscopy, ERCP, capsules, etc.) – Full understanding of CPT and ICD codes.
  • Must have a comprehensive knowledge of insurance carrier policies and procedures – insurance will often provide incorrect/misinformation (such as no authorization required).
  • Our company policy is: they must be two weeks ahead of the scheduled procedures as authorization requests can be delayed/take longer than expected – this requires speed.
  • Eligibility verification for all patients being seen each day using various portals – our EMR (ECW), Navinet, Availity, E-tactics, etc.
  • The ability to comprehend and explain patient benefits – deductibles, coinsurance, copays, any patient responsibility
  • Calling patients to explain these benefits prior to their procedures – need to have an element of customer service and be able to explain and answer questions regarding patient benefits/financial responsibility
  • The ability to effectively communicate with providers, staff, and patients – both written and oral.
  • You will be sending many emails to providers and staff regarding authorization requests, they are also communicating with patients regularly.