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Authorization Review Specialist
2 months ago
Medix™ is seeking a dedicated Prior Authorization Specialist to support a specialized prescription service. This role is crucial in navigating the complexities of healthcare regulations and technology to ensure patients receive essential medications efficiently and affordably.
Key Responsibilities:
- Engage with insurance providers to confirm patient benefits and coverage specifics.
- Oversee the submission process for prior authorization requests for medications through electronic and traditional methods.
- Evaluate clinical documentation to guarantee all necessary information accompanies submissions.
- Record and escalate any challenges encountered during the prior authorization process, including requests for further information from healthcare providers.
- Act as a communication bridge among patients, healthcare professionals, and insurance entities.
- Handle a volume of 40-50 authorizations on a daily basis.
Qualifications:
- A minimum of 1 year of experience in healthcare operations, with a focus on benefits verification, prior authorization, or medical billing and coding.
- Familiarity with medical terminology and the insurance landscape.
- Strong attention to detail and exceptional organizational capabilities.
- Excellent verbal and written communication skills, with proficiency in web-based tools and systems.
- Willingness to work in a collaborative environment.
This position offers a unique opportunity to contribute to a dynamic and rapidly evolving organization.
