MedNetOne

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Prior Authorizations Specialist

Job Description

This is an intake/authorization and administrative role. The Authorization Specialist interacts with clients, insurance companies, patients, as necessary, to request for prior authorizations. It requires being extremely detail oriented and proficient with use of computer systems. The Authorization Specialist is responsible for all aspects of the prior authorization process.

Essential Functions

Responsibilities include:

  • Collecting all the necessary documentation, contacting the parties for additional information and completion of the required prior authorization in order to proceed with procedures.
  • Timely submission of prior and retro authorization requests to the payers. Responsible for documenting account activity, updating patient and claim information and for data entry of incoming procedure authorization requests.
  • Research of patient accounts due to invalid and/or missing authorization information and contacting clients, insurance companies, and patients, to obtain the necessary information.
  • Verification that prior authorizations and/or pre-service requirements are met.

Job Type: Full-time

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Flexible schedule
  • Flexible spending account
  • Health insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift

Knowledge/Skill/Abilities

Required Education

  • High school or equivalent (Preferred)

Required Experience

 

 

Preferred Experience

  • Customer service: 2 years (Preferred)
  • Medical terminology: 2 years (Preferred)

Work Location: One location

Preferred Licensure/Certification

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