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Insurance Verification Specialist
2 months ago
TEKsystems is partnered with a leading physicians clinic seeking a Prior Authorization Specialist to join their diverse and inclusive team in Kansas City, MO if you have recent prior authorization and insurance verification experience, please send your most updated resume to rsison @ teksystems.com - these applications will be reviewed first What You Will Do: Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt. Successfully works with payers via electronic/telephonic and/or fax communications. Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services. Coordinates and supplies information to the review organization (payer) including medical information and/or letter of medical necessity for determination of benefits. Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review. Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate authorization process. Facilitates submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policies and procedures and maintaining departmental productivity and quality goals. Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. Completes accurate documentation in both the Auth/Cert and Referral Shells Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this role may include the following: § Medical, dental & vision About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
