Prior Authorization Specialist

2 weeks ago

Phoenix, AZ, United States SOUTHWEST BREAST AND AESTHETICS LLC Full time
Benefits
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Vision insurance
  • Paid time off
  • Generous paid time off benefits (vacation, holiday, and sick). Two weeks of vacation earned in year one, increasing one week each year until reaching a maximum of four weeks in year four.
  • Fourteen paid holidays per year including your birthday.

We are looking for a dynamic and friendly prior authorization specialist with a minimum of 1 years experience. This position is responsible for obtaining pre-certifications and pre-authorizations for procedures, appointments and medical exams for our patients of our surgical practice.

ESSENTIAL JOB FUNCTIONS
  • Obtain pre-certifications and pre-authorizations for procedures
  • Responsible for verification of patient insurance and eligibility
  • Follow up on all pending authorization requests daily to ensure that authorization is received prior to surgery
  • Update authorizations as needed when insurance plans change or authorization expires
  • Documents authorization notes and status in EMR
  • Assist with maintaining policies & procedure documentation
  • Assist with managing special projects as needed
  • Document all account activity and correspond to inquiries in a timely manner
  • Perform other job-related duties as directed by supervisor
Qualifications and Skills
  • Organized and detail oriented.
  • Excellent time management skills
  • Verify insurance coverage and eligibility.
  • Review of procedure orders and documentation to determine necessity of prior auth.
  • Strong communication skills with providers, team members and patients
  • Excellent written communication skills
  • Detailed documentation of authorization numbers and process for each prior auth
  • Maintain accurate patient medical records.
  • Excellent Customer Service
  • Familiar with using Apple computers
What We are Looking For
  • The ability to build rapport with patients is essential.
  • A willingness to be flexible and adapt as situations require.
  • Ability to remain calm if patient becomes distressed.
  • Personable, optimistic, resilient and possess exceptional interpersonal communication skills.
  • Excellent written and spoken grammar and typing skills.
  • EMR/EHR experience is required (Knowledge of AdvancedMD is preferred)
  • Keen attention to detail.
  • Ability to take direction and correction as needed.
  • Performs other related duties as required or assigned.
  • Document all account activity and correspond to inquiries in a timely manner.
  • Provide outstanding customer service to patients and develop and maintain positive working relationships with internal and other external customers.
  • Verify prior authorizations and/or pre-service requirements are met.
Requirements
  • High school diploma/ GED required.
  • Minimum of 1years experience required.
  • The job is full-time (in the office regular and consistent attendance is required)
  • Job Type: Full-time
  • Pay: From $23.00 per hour
Schedule
  • 8 hour shift
  • Monday to Friday
  • No weekends
Experience
  • Prior Authorization: 1 year (Required)
  • Surgery Pior Authorization (Preferred)

Work Location

One location - Phoenix

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