Prior Authorization Specialist
2 days ago
Prior Authorization Specialist Job Description
We are seeking a skilled Prior Authorization Specialist to join our team at TEKsystems. As a Prior Authorization Specialist, you will play a critical role in ensuring that our clients receive the necessary authorizations for their medical services.
Key Responsibilities:
- Verify insurance eligibility and benefits of prospects/referrals
- Determine LHC rate requirements as it relates to in or out of network coverage
- Communicate patient benefits in a timely manner using the appropriate legacy system and associated software application
- Document and forward patient deductible, out-of-pocket expense, life time maximum, home health or hospice days and patient responsibility to the agency
- Review and reply to branch locations urgent requests
- Obtain all authorization needed from payer for services ordered or requested
- Document specific details related to the authorization including effective and end dates
- Serve as a liaison between the branch location and the payer on a regular basis
- Manage work assignment to ensure all tasks and coordination notes are completed
Requirements:
- High school diploma required
- Former revenue cycle experience is preferred; not required
- EPIC experience is preferred; not required (translates well to their HomeCare/HomeBase system)
- Excellent oral and written communication skills
- Excellent organizational and analytical skills
- Must be a independent and critical thinker
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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