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Insurance Authorization Coordinator

2 months ago

Atlanta, Georgia, United States Southeastern Rheumatology Alliance Full time
Position Overview

Southeastern Rheumatology Alliance is in search of a committed and service-oriented Prior Authorization Specialist to enhance our healthcare operations. This role is pivotal in overseeing and facilitating requests for prior authorization from medical professionals, ensuring that necessary treatments, services, and medications receive appropriate insurance coverage.

Key Responsibilities:

  • Evaluate and manage prior authorization requests from healthcare practitioners.
  • Confirm patient eligibility and benefits, assessing coverage in accordance with insurance guidelines.
  • Collect and submit essential documentation, including medical records and treatment proposals.
  • Adhere to insurance company protocols and organizational policies.
  • Serve as a communication bridge between healthcare providers, insurance entities, and patients to streamline the authorization process.
  • Effectively communicate to gather necessary information, address inquiries, and resolve complications.
  • Handle and rectify issues concerning denied or pending authorizations.
  • Propose solutions or alternatives when required and ensure follow-up for resolution.
  • Monitor the progress of pending authorizations to guarantee prompt processing.

Qualifications:

  • A minimum of 1 year of experience in a healthcare setting.
  • An associate degree or a combination of education and relevant experience in a customer service role.
  • Familiarity with medical terminology.

Benefits:

We offer a collaborative and supportive work environment, a 4-day work week (Monday-Thursday), and a competitive benefits package that includes group medical, dental, vision, short-term and long-term disability insurance, paid holidays, paid time off, and a 401K plan.