Prior Authorization Specialist
6 days ago
Clay County Medical Center is seeking a skilled Prior Authorization Specialist to join our team. As a Prior Authorization Specialist, you will play a critical role in ensuring that patient services are authorized in a timely and efficient manner. This is a full-time position that requires strong communication and organizational skills, as well as the ability to work independently and as part of a team.
Key Responsibilities:
- Monitor schedules to determine which patient services require prior authorization and obtain approval for those tests.
- Receive and process requests for prior authorizations through the electronic health record (EHR) and/or via phone or fax.
- Manage correspondence with insurance companies, physicians, and specialists as needed, including documenting in the EHR as appropriate.
- Review accuracy and completeness of information requested and ensure that all supporting documents are present.
- Review denials and follow up with providers to obtain medically necessary information to submit an appeal of the denial.
Requirements:
- High school diploma or equivalent.
- Previous experience in a medical office and/or clinical setting preferred.
- Knowledge of insurance process and medical terminology preferred.
- Ability to work independently and as part of a team.
- Strong communication and organizational skills.
What We Offer:
- Full benefit package including insurances, retirement, paid time off, and medical leave.
- Opportunity to work with a dynamic and growing healthcare organization.
How to Apply:
Interested candidates should submit their resume and a cover letter to [insert contact information].
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