Prior Authorization Specialist

6 days ago


Clay Center, United States Clay County Medical Center Full time
Prior Authorization Specialist Job Summary

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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