Prior Authorization Specialist

2 weeks ago


Minneapolis, Minnesota, United States TAJ Technologies Inc Full time
POSITION SUMMARY

The Prior Authorization Specialist plays a crucial role in ensuring that patients receive timely access to necessary therapies by verifying and obtaining prior authorizations as needed. This position involves direct collaboration with healthcare providers and insurance companies to facilitate the authorization process.

KEY RESPONSIBILITIES
  • Assess and confirm prior authorization requirements, obtaining necessary approvals in a timely manner.
  • Engage with physician offices and insurance payers to streamline patient access to treatments.
  • Evaluate patient insurance coverage and communicate any discrepancies or issues to management.
  • Initiate and manage the submission of required documentation, including clinical notes and forms, to support authorization requests.
  • Maintain regular follow-ups to track the status of authorization requests throughout the approval process.
  • Possess a foundational understanding of the payer payment process, with specialized knowledge of the prior authorization protocols.
  • Demonstrate familiarity with ICD9/10 and CPT coding, particularly regarding Medtronic therapy codes.
  • Exhibit exceptional customer service abilities, with strong communication skills for interaction with various stakeholders, including healthcare providers and insurance representatives.
  • Utilize advanced Microsoft Excel skills and adapt to various CRM software applications as required.
  • Display strong organizational capabilities, managing multiple inquiries simultaneously while applying critical problem-solving skills and maintaining attention to detail.


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