Prior Authorization Coordinator
2 months ago
We are seeking a highly organized and detail-oriented Prior Authorization Coordinator to join our team at Regal Medical Group. As a Prior Authorization Coordinator, you will play a critical role in facilitating the referral process and ensuring that patients receive the right care at the right time.
Key Responsibilities- Process requests from Access Express that are pended or reprocess approved or denied authorizations and package properly for review and resolution.
- Check eligibility and benefits on all DME and home health authorizations prior to forwarding on request to prior authorization nurse or medical director for approval.
- Capture any leakage and provide feedback to the leadership team for additional training.
- Maintain turnaround time compliance in all aspects of the Prior Authorization process.
- Work in collaboration with the department Prior Auth Assistants, Specialists, Team Leads, Supervisor, Managers and Regional Medical Directors and Network Managers to ensure a level of referral processing that meets or exceeds the organization's expectation.
- High School graduate required; Associates in Arts degree preferred.
- Ability to operate PC based software programs or data base management systems.
- Knowledge of computers, faxes, printers and all other equipment.
- Proficient in MS Office programs (i.e. Word, Excel, Outlook, Access and PowerPoint).
- 1-2 years IPA or Medical office experience.
- Experience with prior authorization process strongly preferred.
- Knowledge of Healthcare and Managed Care preferred.
- Typing 60 words per minute with accuracy.
- Must possess strong organizational skills and be detail oriented.
- Ability to multi-task and meet turnaround times.
- Proficient with turnaround time compliance in all aspects of the PA Process.
- Ability to deal with responsibility with confidential matters.
- Ability to work in a multi-task, high energy environment.
We offer a comprehensive benefits package, including health and wellness benefits, savings and retirement plans, and other perks. Our team is dedicated to providing a supportive and collaborative work environment that allows our employees to thrive and grow in their careers.
Regal Medical Group is an equal opportunity employer and welcomes applications from qualified candidates who share our commitment to excellence and patient care.
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