Medical Prior Authorization Specialist

Found in: Lensa US P 2 C2 - 2 weeks ago

Hinsdale, United States AFC Urgent Care Full time

Company Overview:

Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time Prior Authorization Specialist with a can-do attitude and strong professionalism. You must be computer savvy for this position. We are EMR based, using EMA; Experience with EMA is very beneficial, but not required. Looking for candidates who want a long-term, stable position with opportunity for advancement.

Position Highlights: The Prior Authorization Specialist is responsible for obtaining and resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all payers. In addition, the Prior Authorization Specialist may be responsible for pre-appointment registration and insurance review to maximize the submission of a clean claim.

Position Responsibilities:

  • Reviews, collects and properly records demographic and insurance information required to properly address the customers' authorization requirements and identify any financial issues. Verifies patient's eligibility from resources provided by third party payers and portals and other on lines services.

-Collects and analyzes demographic, insurance and other information from the patient, guarantor and all other sources to accurately obtain authorization for scheduled procedure.

-Assembles information concerning the patient's clinical background and clinical information that is required for the payer to issue a referral or an authorization. Per referral guidelines, provide appropriate clinical information to the payer.

-Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis, CPT codes and clinical notes.

-Performs registration functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including HIPAA privacy.

-Consistently maintains authorization accuracy rates at and or above department standard in performance of registration and authorization duties.

  • Able to find resolution within the phone interaction satisfactory to the caller and/or having the knowledge when to escalate to their supervisor.

  • Receives and properly responds to, or directs telephone and electronic inquiries from patients, payers, physicians and their staff, internal department and other persons and entities.


-Ability to exercise good customer service skills when communicating with both our patients as well as our internal customers.

-Able to find resolution within the phone interaction satisfactory to the caller and/or having the knowledge when to escalate to their supervisor.

-Performs other duties as assigned for the operational effectiveness and success of the department.

Required Job Qualifications:

  • High school graduate or equivalent.

  • 1 year of experience

  • Excellent communication and outstanding customer service and listing skills.

  • Basic keyboarding skills

  • Ability to analyze and interpret data

  • Critical thinking, sound judgment and strong problem-solving skills essential

  • Team oriented, open minded, flexible, and willing to learn

  • Strong attention to detail and accuracy required

  • Ability to prioritize and function effectively, efficiently, and accurately in a multi-tasking complex, fast paced and challenging department.

  • Ability to follow oral and written instructions and established procedures

  • Ability to function independently and manage own time and work tasks

  • Ability to maintain accuracy and consistency

  • Ability to maintain confidentiality

  • Experience in Pain Specialty is Preferred

  • Medical Prior Authorization Specialist

    7 days ago

    Hinsdale, United States AFC URGENT CARE Full time

    Company Overview: Position Highlights: The Prior Authorization Specialist is responsible for obtaining and resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all payers. In addition, the Prior Authorization Specialist may be responsible for pre-appointment registration and insurance review to...

  • Medical Prior Authorization Specialist

    1 week ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time Prior Authorization Specialist with a can-do...

  • Medical Prior Authorization Specialist

    24 hours ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time Prior Authorization Specialist with a can-do...

  • Digital Marketing Specialist

    6 days ago

    Hinsdale, United States Healing Medical & Aesthetics Full time

    Company Description Healing Medical & Aesthetics is a premier Medical & Aesthetic practice located in Hinsdale, IL. We provide exceptional cosmetic services in a luxurious and relaxing environment. Our dedicated team of skilled and experienced professionals are committed to helping our clients look and feel their best through a range of non-invasive cosmetic...

  • Digital Marketing Specialist

    Found in: Appcast Linkedin GBL C2 - 7 days ago

    Hinsdale, United States Healing Medical & Aesthetics Full time

    Company Description Healing Medical & Aesthetics is a premier Medical & Aesthetic practice located in Hinsdale, IL. We provide exceptional cosmetic services in a luxurious and relaxing environment. Our dedicated team of skilled and experienced professionals are committed to helping our clients look and feel their best through a range of non-invasive cosmetic...

  • Medical Billing

    7 days ago

    Hinsdale, United States AFC URGENT CARE Full time

    **Company Overview**: **Basic Job** **Responsibilities** - Daily claim billing and auditing for accuracy - Posting insurance payments including electronic and paper - Resolve claim edits/exclusions - Understanding billing guidelines and payor requirements. - Perform prior authorization functions as needed - Follow-up on unpaid claims to ensure prompt payment...

  • Medical Billing

    1 week ago

    Hinsdale, United States AFC URGENT CARE Full time

    Job DescriptionJob DescriptionCompany Overview:  Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions.  We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time biller with a can-do attitude and strong...

  • Medical Billing

    1 day ago

    Hinsdale, United States AFC URGENT CARE Full time

    Job DescriptionJob DescriptionCompany Overview:  Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions.  We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time biller with a can-do attitude and strong...

  • Medical Billing

    1 week ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time biller with a can-do attitude and strong...

  • Medical Billing

    24 hours ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time biller with a can-do attitude and strong...

  • Medical Coder

    7 days ago

    Hinsdale, United States AFC URGENT CARE Full time

    Company Overview: Description: The Medical Coder reflects the mission, vision, and values of our practice, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Medical Coder performs Current Procedural...

  • Medical Assistant/CNA/PCT

    Found in: Talent US C2 - 2 weeks ago

    Hinsdale, United States Duly Health and Care Full time

    Overview Location: Hinsdale; Occasional travel to Downers Grove, Elmhurst, Lisle, and Oakbrook required Hours: 40 hours per week; Monday - Friday 8:00am - 5:00pm Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of...

  • Medical Coder

    2 weeks ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time coder with a can-do attitude and strong...

  • Medical Coder

    1 hour ago

    Hinsdale, United States AFC Urgent Care Full time

    Job DescriptionJob DescriptionCompany Overview:Modern Pain Consultants is a renowned Interventional Pain Practice committed to providing exceptional patient care and innovative pain management solutions. We are a well-established, higher volume Interventional Pain Practice seeking a seasoned, talented full-time coder with a can-do attitude and strong...

  • Medical Assistant

    7 days ago

    Hinsdale, United States AFC URGENT CARE Full time

    Company Overview: Morris, New Lenox & Hinsdale Modern Pain Consultants is a renowned interventional pain practice committed to providing exceptional patient care and innovative pain management solutions. We are seeking a skilled and compassionate Medical Assistant to join our dynamic team. As a Medical Assistant in our interventional pain practice, you will...

  • Full Time Medical

    1 week ago

    Hinsdale, United States Midwest Skin Cancer Institute, LLC Full time

    Superstar Full Time and Part Time Mohs Surgery / Procedural Dermatology Certified Medical Assistant needed!Excellent opportunity for those seeking experience prior to PA school and for advancement in health professions!Want to work with one of the best offices in Illinois, where you are appreciated for your efforts and where everyone gets along? Want to work...

  • Full Time Medical

    Found in: Appcast US C2 - 1 week ago

    Hinsdale, United States Midwest Skin Cancer Institute, LLC Full time

    Superstar Full Time and Part Time Mohs Surgery / Procedural Dermatology Certified Medical Assistant needed!Excellent opportunity for those seeking experience prior to PA school and for advancement in health professions!Want to work with one of the best offices in Illinois, where you are appreciated for your efforts and where everyone gets along? Want to work...

  • Full Time Medical

    Found in: Appcast Linkedin GBL C2 - 2 weeks ago

    Hinsdale, United States Midwest Skin Cancer Institute, LLC Full time

    Superstar Full Time and Part Time Mohs Surgery / Procedural Dermatology Certified Medical Assistant needed!Excellent opportunity for those seeking experience prior to PA school and for advancement in health professions!Want to work with one of the best offices in Illinois, where you are appreciated for your efforts and where everyone gets along? Want to work...

  • RN, Registered Nurse

    1 week ago

    Hinsdale, United States Dupage Medical Group Full time

    RN, Registered Nurse - Immediate CareOverview LOCATION: Hinsdale SCHEDULE: Full-time, Monday- Friday, 2-3 days a week: 8:00am-8:00pm; Every other Saturday and Sunday, 9:00-4:00pm Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We challenge assumptions and invite dissent to accomplish bold...

  • RN, Registered Nurse

    1 week ago

    Hinsdale, United States Dupage Medical Group Full time

    RN, Registered Nurse - Immediate CareOverview LOCATION: Hinsdale SCHEDULE: Full-time, Monday- Friday, 2-3 days a week: 8:00am-8:00pm; Every other Saturday and Sunday, 9:00-4:00pm Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We challenge assumptions and invite dissent to accomplish bold...