Prior Authorization Specialist

4 days ago


Tucson, United States The Temp Connection Full time
Job DescriptionJob Description

The Prior Authorization Specialist is responsible for obtaining pre-authorizations from insurance carriers. Inputs the data accurately and timely into the EMR software. Review daily schedules to determine which payors require prior authorization. Review clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedure for authorization request. Knowledgeable in medical terminology, CPT codes, ICD-10, NCCI edits and LCD policies. 
Communicate with the scheduling department to make sure they know when they are able to schedule patients. Contact patients to let them know if their insurance has denied their authorization request. Work directly with patients to have them assist with obtaining prior authorization from their insurance carrier when needed.
The position will also perform light administrative duties and any other tasks as assigned by the Revenue Cycle Manager.

Qualifications and Education Requirements

Minimum two years’ experience in Medical Insurance billing experience required.
Minimum of one-year experience with prior authorization experience (healthcare preferred). 

Preferred Skills

  • Computer skills including web browsing, excel, and EMR software
  • Excellent verbal and written communication skills
  • Knowledge of medical terminology, CPT codes and ICD-10
  • Ability to analyze data given to provide the appropriate information to insurance companies
  • Ability to respond to questions in a tactful and professional manner
  • Excellent people skills: ability to work independently and as a team member
  • Understanding of HIPPA regulations, respect for patient confidentiality
  • Strong work ethic with an ability to multi-task
  • Proficiency towards all responsibilities and attention to detail
Company DescriptionIn addition to paying wages, we are responsible for withholdings, payroll taxes, workers’ compensation, unemployment, liability and bonding.

Our employers appreciate the quick access to more candidates which affords them flexible workforce solutions. Job seekers appreciate the access to positions that they may otherwise not have known about.Company DescriptionIn addition to paying wages, we are responsible for withholdings, payroll taxes, workers’ compensation, unemployment, liability and bonding.\r
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Our employers appreciate the quick access to more candidates which affords them flexible workforce solutions. Job seekers appreciate the access to positions that they may otherwise not have known about.

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