Prior Authorization Specialist
- Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
- Request, track and obtain prior authorization from insurance carriers within time allotted for medical services.
- Request, follow up and secure prior authorizations prior to services being performed.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Communicate any insurance changes or trends among team.
- Maintains a level of productivity suitable for the department.
- Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
- Other duties as assigned.
- Patient First – An approach to care that holds primary, the well-being and desires of the patient
- Build not Blame – Focusing first on finding fault with the process rather than the person
- Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers
- C ooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description
- Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.
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