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Clinical Review Pharmacist
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Prior Authorization
3 months ago
**Prior Authorization Specialist**
At Pima Pain Center, our team members focus on transforming the patient experience and delivering exceptional quality care. Patients choose Pima Pain Center because of our experienced healthcare team and mínimally invasive approach to pain management, resulting in cost-effective treatments with less trauma and pain, and a faster recovery time.
The Prior Authorization Specialist is responsible for the day-to-day process to verify patient eligibility and benefits in order to work with the patient insurance company to obtain procedural authorization's for services provided to our patients.
**Job Duties**:
- Prioritizes incoming prior authorization requests
- Review task sent, complete task, review authorization log to verify all request are being met.
- Provides needed documentation to insurance companies in accordance with mandated insurance regulations via fax, online, or telephone to obtain procedure authorizations.
- When needed, sets up "Peer to Peer" for physicians to provide requested information to the insurance plan.
- Verifying insurance benefits for commercial and governmental payers
- Efficiently obtain all authorizations for procedures prior to the day of service
- Calling all patients to ensure appointment times are confirmed prior to appointment, while confirming the patient is in good health and following practice policy to perform any procedure
- Works with physicians and office staff when clinical information is required to coordinate insurance authorizations
**Minimum Qualifications**:
- High School Diploma or Equivalent
- 3-5 years medical office experience in procedural authorizations
**Benefits**:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
- Wellness program
Weekly day range:
- Monday to Friday
- No weekends
**Experience**:
- Medical Procedure Prior Authorization: 1 year (required)
Work Location: In person
