Insurance Authorization Coordinator

1 week ago


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

The 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 managing and facilitating requests for prior authorization from medical professionals, ensuring that treatments, services, and medications are adequately covered by insurance providers.

Key Responsibilities:

  • Evaluate and manage prior authorization requests from healthcare practitioners.
  • Confirm patient eligibility and benefits, assessing coverage according to insurance guidelines.
  • Collect and submit necessary documentation, including medical records and treatment plans.
  • Adhere to insurance company protocols and internal policies.
  • Serve as a communication bridge between healthcare providers, insurance entities, and patients to streamline the authorization process.
  • Effectively communicate to gather essential information, address inquiries, and resolve challenges.
  • Handle and resolve issues concerning denied or pending authorizations.
  • Offer solutions or alternatives when required and follow up to ensure resolution.
  • Monitor the status of pending authorizations, ensuring efficient processing.

Qualifications:

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

Benefits:

We offer a collaborative and team-focused work environment, a 4-day work week, 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.



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