Prior Authorization Specialist

2 weeks ago


Uniontown, Alabama, United States MedOP Solutions Full time
Job Overview

MedOP Solutions is seeking a skilled Prior Authorization Specialist to collaborate with our Benefits Verification Team. As a key member of our team, you will play a crucial role in ensuring patients have access to necessary care.

Key Responsibilities:
  • Insurance Verification: Validate insurance plans and prescriptions to ensure accurate coverage.
  • Clinical Documentation: Contact physicians to obtain clinical documentation for prior authorization purposes.
  • Prior Authorization Management: Initiate and follow up on prior authorizations within 48 hours, ensuring timely processing.
  • Re-Authorization Management: Manage re-authorizations and ensure timely processing to minimize delays.
Requirements:
  • Experience: Proven experience with major medical insurance and pharmacy benefits.
  • Knowledge: Strong understanding of HCPC (J-Codes) and ICD-10 codes.
  • Communication Skills: Excellent communication and attention to detail.

At MedOP Solutions, we are committed to making a difference in patients' lives. If you are passionate about delivering exceptional care and have the necessary skills, we encourage you to apply for this exciting opportunity.



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