Prior Authorizations Specialist

2 days ago


Signal Hill, California, United States Food Allergy Institute Full time
About Food Allergy Institute

Founded in 2015, Food Allergy Institute is a pioneering research and clinical care center revolutionizing food allergy treatment among the pediatric population.

We are committed to providing life-changing treatments for our patients and their families, and we're seeking a highly skilled Prior Authorizations Specialist to join our team.

Job Summary

The Prior Authorizations Specialist will play a crucial role in ensuring that patients receive necessary treatments in accordance with their insurance coverage. This position requires strong communication skills, attention to detail, and the ability to work in a fast-paced environment.

Key Responsibilities
  • Review and submit prior authorization requests for medical services, procedures, labs, and medications to insurance companies or third-party payers.
  • Verify patient insurance coverage, eligibility, and plan limitations to determine the necessity of prior authorization.
  • Communicate with healthcare providers (physicians, providers, nurses, etc.) to gather required documentation, such as medical histories and prescriptions.
  • Submit claims and follow up with insurance companies for approvals, denials, or further information requests.
  • Address any denied claims by working with healthcare providers to submit appeals or adjust the requested services or medications.
  • Inform patients about the status of their prior authorization requests, insurance coverage, and potential out-of-pocket costs.
  • Maintain accurate and detailed records of all authorization requests, approvals, denials, and communications in the medical management system.
Requirements
  • High school diploma or equivalent required; completion of medical billing and coding or Medical Assistant program preferred.
  • At least 2-3 years of experience as a Medical Assistant or with prior authorizations.
  • Knowledge of medical terminology and insurance processes.
  • Experience with medical billing systems and electronic health records (EHR).
  • Strong organizational and time management skills, with attention to detail and follow-up.
  • Excellent verbal and written communication skills, with strong interpersonal and customer service skills.
  • Ability to work in a fast-paced environment, with strong multi-tasking skills and a positive working attitude.
Compensation and Benefits

We offer a competitive salary of $23-$25 per hour, depending on experience, plus a range of benefits including:

  • Health Insurance
  • Vision Insurance
  • Dental Insurance
  • PTO Days
  • Paid Holidays
  • 401K Plan (matched)
  • Professional Development
  • Paid Training
  • Company Sponsored Events
  • Competitive Rates
  • Growth Opportunities

$51,840 - $52,000 per year based on 40 hours/week, assuming an hourly rate of $25.



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