Prior Authorization Specialist

1 week ago


Atlanta, Georgia, United States Prestige Staffing Full time
Job Title: Prior Auth

Job Overview:

Prestige Staffing is seeking a skilled Prior Auth Specialist to join our team. As a Prior Auth Specialist, you will play a critical role in ensuring that patients receive the necessary medical procedures and treatments in a timely manner.

Responsibilities:

  • Initiate and follow up on precertification for commercial payers to obtain necessary approvals
  • Obtain benefits and eligibility for professional fees from insurance companies and inform patients accordingly
  • Ensure all DME and MRI/X-ray/CT scan requests are forwarded to facilities prior to surgery dates
  • Consult with patients to schedule surgeries and procedures while addressing any questions or concerns
  • Collect surgery deposits and assist patients with setting up payment plans, educating them on financial responsibility, and informing the AR team of patient information and payment plans
  • Enter surgery dates and post-operative visits into the EMR system
  • Email surgery packets to patients, including pre-op and surgery instructions, post-op appointments, and reminders of any balances to be collected prior to surgery dates
  • Consolidate surgery packets and forward them to facilities scheduled for procedures
  • Coordinate COVID-19 testing for non-vaccinated patients
  • Coordinate surgeries with other physicians and vendors
  • Assist with pre-op medical clearance for scheduled procedures
  • Assist with clinic and patient workflow as needed
  • Document authorizations in the EMR system
  • Coordinate direct admissions to nearby hospitals for CTCA and LBS patients
  • Schedule and coordinate all parties involved during patient surgeries, including outside vendors, first assistants, anesthesia companies, and neuro-monitoring companies

Requirements:

This role requires excellent communication and organizational skills, as well as the ability to work effectively in a fast-paced environment. The ideal candidate will have a strong understanding of medical procedures and protocols, as well as experience working with insurance companies and healthcare providers.

What We Offer:

Prestige Staffing offers a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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