Medical Authorization Specialist
3 weeks ago
Location HybridDepartment Business OfficeJob Type Full-TimeAt GI Associates we believe in striving for the best outcomes for our patients, employees, and community. GI Associates is looking for motivated people to join our growing independent gastroenterology practice. Our nationally recognized physicians and dedicated team are patient-focused and provide compassionate, collaborative care to patients across Southeast Wisconsin.GI Associates provides an excellent work-life balance and amazing benefits package including:
- No weekends
- No Holidays
- PTO & paid anniversary day
- 7% GI Associates retirement contribution & 401(k) plan
- Medical, dental & vision insurance
- Flexible spending plan
- Short- & long-term disability
- Basic & supplemental life insurance
Position Responsibilities:· Verifies eligibility and benefit levels to ensure adequate coverage at correct site of service.
· Obtains pre-certification, authorization, and referral approval for required services for both the facilityand professional services
· Ensures timely and accurate insurance authorizations/referrals are in place prior to services being rendered.
· Provides detailed documentation and communication with both payors and clinicians to obtain priorauthorizations.
· Obtains and submits clinical information to support medical necessity.
· Coordinates peer-to-peer reviews, when required by payors.
· Completes accurate documentation in our practice management system.
· Assist with denials related to pre-certification as needed.
· Respond to internal/external emails and inquiries in a timely, accurate and complete manner.Minimum Qualifications:· 1-3 years· Familiar with ICD-10 and CPT codes· Familiar with Medical Terminology· Communicates effectively and professionally
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Prior Authorization Specialist
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Prior Authorization Representative
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Prior Authorization Representative
3 days ago
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