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Medical Prior Authorization Specialist for Sleep Medicine

1 month ago

Fountain Hill, Pennsylvania, United States ST. LUKE'S UNIVERSITY HEALTH NETWORK Full time
About the Role

As a Medical Prior Authorization Specialist at St. Luke's University Health Network, you will play a vital role in ensuring seamless patient care by coordinating prior-authorizations and referrals for specialty services.

Responsibilities
  • Verify patient demographics and insurance information to obtain accurate prior authorization for specialty care and services.
  • Review patient insurance eligibility and verify coverage to ensure timely reimbursement.
  • Obtain prior authorization from insurance companies before services are rendered.
  • Document all communication with patients, providers, and insurance companies in the electronic health record (EHR).
  • Collaborate with cross-functional teams to ensure smooth patient flow and efficient communication.
Requirements

We are seeking an experienced medical professional with excellent communication and organizational skills. A high school diploma or equivalent is required, and prior authorization experience is preferred.

A minimum of one to two years of experience in medical billing, a medical office, or insurances is desired. Working knowledge of medical office procedures, ICD 10, and CPT codes is necessary. Familiarity with regulatory standards and compliance requirements is also essential.

About Us

St. Luke's University Health Network is an equal opportunity employer committed to providing exceptional care to our patients and their families. We value diversity and inclusion in our workplace and encourage applications from qualified candidates.