Prior Authorization Nurse, Urgent Need

3 weeks ago


Austin, United States Cam Bay Health Care Full time

Overview:
We are seeking a detail-oriented and organized individual to join our team as a Prior Authorization Specialist. As a Prior Authorization Specialist, you will play a crucial role in ensuring that insurance claims are processed accurately and efficiently. This position requires knowledge of medical coding, insurance verification, and adherence to HIPAA regulations.

**Responsibilities**:

- Review and process prior authorization requests for medical procedures, medications, and treatments
- Verify insurance coverage and eligibility for patients
- Communicate with healthcare providers, insurance companies, and patients regarding authorization status and requirements
- Obtain necessary documentation and medical records to support the prior authorization request
- Ensure compliance with ICD-9 and ICD-10 coding guidelines
- Maintain accurate records of prior authorization requests and follow-up activities
- Collaborate with the billing department to resolve any issues related to prior authorizations

Qualifications:

- Previous experience working in a dental or medical office setting preferred
- Strong knowledge of medical coding systems, including ICD-9 and ICD-10
- Familiarity with insurance verification processes and requirements
- Understanding of HIPAA regulations and ability to maintain patient confidentiality
- Excellent attention to detail and organizational skills

**Job Type**: Contract

Pay: $20.47 - $40.00 per hour

Expected hours: No less than 36 per week

**Benefits**:

- Flexible schedule

Weekly day range:

- Monday to Friday

**Experience**:

- Insurance verification: 1 year (preferred)
- Medical billing: 1 year (preferred)

License/Certification:

- RN License of Texas State (preferred)

Ability to Commute:

- Austin, TX (required)

Work Location: In person



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