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Prior Authorization Specialist
2 months ago
We are seeking a highly skilled Prior Authorization Specialist to join our Clinical Services Team at Neuroscience Group of Northeast Wisconsin S.C.
Key Responsibilities:
- Collect and verify patient insurance information to ensure accurate pre-authorization
- Review clinical documentation to determine medical necessity for pre-authorization
- Initiate prior authorization requests and follow up on pending requests
- Collaborate with healthcare providers to ensure patient care and resolve any issues
- Review denied cases and work with the team to develop appeals
Requirements:
- Medical preauthorization experience with a strong understanding of healthcare insurance
- Knowledge of CPT and ICD-10 coding
- Previous experience with EPIC
- Strong organizational and communication skills
Working Conditions:
- Primarily seated work with some position changes
- May involve lifting supplies
- Normal hearing and eyesight required
Benefits:
- No nights, weekends, or holidays
- Comprehensive health, dental, and vision insurance
- Long term disability and life insurance
- Generous PTO and retirement plans
