Prior Authorization Representative
3 weeks ago
Job Title: Customer Service Rep II
Location: Alabama - Remote
Duration: 2 Years
Summary:
- The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required.
- Works directly with physician offices and payers to facilitate patient access to various therapies.
- Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization.
- Assists with appealing prior authorization denials, retro authorization or other special cases
Responsibilities Include, But Are Not Limited To
- Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers.
- Checks the requirements for prior authorization and initiates as required.
- Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required.
- Follows up frequently to ensure visibility on authorization status throughout the approval process.
- Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process.
- Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of Medtronic therapy codes.
- Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders.
- Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed.
- Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail.
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Prior Authorization Representative
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Birmingham, United States Three Point Solutions Full timeJob DescriptionJob DescriptionJob Title - Prior Authorization Representative - Non-Exempt - 14093Number of Positions 1Job Location - Virtual LocationJob Start Date - 5/20/24Job End Date - 5/19/26Job Description -The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required....
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Prior Authorization Representative
3 weeks ago
Birmingham, United States Three Point Solutions Full timeJob DescriptionJob DescriptionJob Title - Prior Authorization Representative - Non-Exempt - 14093Number of Positions 1Job Location - Virtual LocationJob Start Date - 5/20/24Job End Date - 5/19/26Job Description -The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required....
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