Prior Authorization Specialist

4 weeks ago


Mount Juliet, Tennessee, United States LifePoint Health Full time

Prior Authorization Coordinator Job Summary

The Prior Authorization Coordinator plays a vital role in ensuring seamless patient care by processing inbound prior authorizations for the department. This role requires strong communication and organizational skills to coordinate the authorization process, meeting the needs of patients, community specialists, and physicians.

Key Responsibilities:

  • Review chart documentation to ensure patients meet medical policy guidelines
  • Prioritize incoming authorization requests according to urgency
  • Obtain authorization via the payer website or by phone
  • Follow up regularly on pending cases
  • Initiate appeals for denied authorizations
  • Respond to clinic questions regarding payer medical policy guidelines
  • Confirm the accuracy of CPT and ICD-10 diagnoses in the procedure order
  • Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations

Requirements:

  • Ability to interact effectively with patients, physicians, and insurance companies
  • Strong organizational and communication skills
  • Ability to work in a fast-paced environment

About LifePoint Health

LifePoint Health is a leading healthcare provider dedicated to delivering high-quality patient care. We are committed to creating a positive and supportive work environment that fosters growth and development.



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