Join Our Team

Handles the submission and tracking of prior authorization requests.

Communicates with healthcare providers and insurance companies to obtain necessary approvals.

Assists with gathering patient information and supporting documentation for prior authorization.

Manages prior authorizations for medications, ensuring proper documentation and communication with prescribers and insurers

Completes necessary clinical documentation to support the prior authorization request.

Communicates with the prior authorization team to address any questions or additional information needed.

Ensures that the correct codes are used for procedures or medications that require prior authorization.

Collaborates with the prior authorization team to ensure compliance with insurance policies.

Collect and verify patient information, including insurance details and medical history.

Submit prior authorization requests to the appropriate insurance payers, including required documentation.

Gather supporting documentation such as medical records, test results, and clinical notes to justify the need for the requested service.

Serve as the primary point of contact between healthcare providers, patients, and insurance companies.

Provide updates to providers and patients regarding the status of prior authorization requests.

Monitor the status of submitted requests and follow up with insurance companies to expedite the approval process.

Ensure compliance with HIPAA regulations regarding patient confidentiality.

Degree: An associate's or bachelor’s degree in healthcare administration, medical billing and coding, nursing, or a related field is often preferred.

Healthcare Experience: Previous experience in a healthcare setting, particularly in roles related to medical billing, coding, or prior authorization, is highly beneficial.

Knowledge of Insurance: Familiarity with various insurance policies, prior authorization processes, and medical coding systems (ICD-10, CPT) is crucial.

Claims Management: Experience in handling claims submissions and denials can enhance a candidate’s qualifications.

Computer Proficiency: Strong skills in electronic health record (EHR) systems and billing software. Familiarity with claims processing software is a plus.

Data Entry: Excellent typing skills and attention to detail for accurate documentation and data entry.

Communication: Strong verbal and written communication skills to effectively liaise with healthcare providers, patients, and insurance representatives.

Problem Solving: Ability to analyze denial reasons, develop appeals, and identify trends to improve the authorization process.

Attention to Detail: Careful review of medical records and documentation to ensure accuracy and compliance with insurance requirements.

Adaptability: Flexibility to adapt to changing policies, regulations, and technologies in the healthcare landscape.

Team Player: Willingness to collaborate with healthcare professionals and support staff to achieve common goals.

Continuous Learning: Commitment to staying updated on changes in healthcare regulations, insurance policies, and prior authorization processes.

• Excellent working atmosphere
• Salary and bonus always paid on-time
• You work for a company that has continuously grown for past 18+ years
• Very supportive senior management
• And lots more