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Authorization Specialist

2 months ago

Mount Juliet, Tennessee, United States Center for Spine, Joint, Neuromusuclar Rehabilitation Full time
Job Overview

Position Title: Prior Authorization Specialist

The Prior Authorization Specialist will play a crucial role in securing necessary authorizations for various medical services. This includes obtaining approvals for medications, procedures, prescriptions, and diagnostic tests. The role demands a professional demeanor and effective communication skills to interact with patients, pharmaceutical representatives, healthcare providers, pharmacies, and insurance companies to gather the essential information needed for processing authorizations.

Key Responsibilities

  • Engage in clear and effective communication, both in person and via phone, to foster collaborative relationships with patients, healthcare providers, pharmaceutical representatives, and insurance personnel.
  • Prepare and provide patients with the required authorization documentation for their review and signature, ensuring all forms are complete and accurate.
  • Confirm the eligibility of patients' pharmacy insurance coverage.
  • Utilize electronic medical records (EMR) and specialty pharmacy portals efficiently for medication management.
  • Document all interactions with patients, pharmacies, and insurance carriers accurately in the EMR system.
  • Handle the copying, faxing, and mailing of documents as requested by insurance companies.
  • Coordinate follow-up appointments and necessary injections.

Required Skills and Attributes

  • Attention to Detail: Ability to perform tasks with precision and thoroughness.
  • Effective Communication: Strong verbal and written communication skills.
  • Technical Proficiency: Competent in using computers and electronic medical records.
  • Confidentiality: Uphold the confidentiality of patient and organizational information, adhering to HIPAA regulations.
  • Customer Service Focus: Maintain a friendly and helpful attitude towards patients and colleagues, ensuring their needs are met while adhering to office policies.
  • Adaptability: Ability to adjust to changing work conditions and responsibilities.
  • Multitasking: Capable of managing multiple tasks simultaneously.
  • Resilience: Ability to perform effectively under pressure.

Work Environment

  • Controlled medical office setting.
  • Fast-paced atmosphere with occasional high-pressure scenarios.
  • Regular interaction with a diverse group of individuals, including team members, healthcare providers, patients, and insurance representatives.