Prior Authorization Specialist_

JOB DESCRIPTIONJOB TITLE: Prior Authorization Specialist – CardiologyJOB STATUS: Full-time, Non-ExemptDIVISION/LOCATION: CardiologyREPORTS TO: Practice ManagerJOB SUMMARY: Position entails working with insurance companies to obtain prior authorizations for Medications, Nuclear & Exercise Stress Testing, CTA procedures, Cardiology Imaging, which includes, but not limited to Echos, Carotids. Authorizing of radiology testing being performed at an external radiology facility, PVR and Holter Monitor Testing.DUTIES AND RESPONSIBILITIES:+ Contact insurance companies to obtain prior authorizations as required by patients’ insurance plan. Obtain authorizations in a timely fashion.+ As necessary, give priority to add-ons and same-day appointments in order to make every effort authorization is in place prior to service.+ Authorizations should be obtained within 72 hours of receipt of request.+ Document with high degree of accuracy all correspondence with insurance companies. Work with clinical staff and providers to gather additional information to obtain prior authorization as needed.+ Coordinate patients’ procedures for both the office, as well as outside facilities.+ Complete surgical booking sheets and all required documentation needed for procedure(s) to be scheduled and performed.+ Obtain patients' insurance eligibility and benefits.+ Collaborate with Premier's billing department when required.+ Provide excellent customer service by appropriately responding to inquiries from clinical staff, providers, and/or patients.+ Rely on instructions, protocols and pre-established guidelines to perform the functions of the job.+ Perform other related duties as assigned or requested.+ Assist other members of the department, providing cross coverage as needed.EDUCATION & EXPERIENCE:+ Minimum of a High School diploma; Associate degree preferred.+ 3 years relevant healthcare experience and/or training. Experience with obtaining authorizations.QUALIFICATIONS & REQUIREMENTS:+ Demonstrated ability of critical thinking skills to efficiently organize work and maintain a high level of accuracy and productivity.+ Working knowledge and ability to navigate through the healthcare system (insurances, Medicare, Medicaid, physician office operations).+ Prior experience working with EMR systems.+ Knowledge of commonly used medical terms and procedures.+ Strong organizational skills.+ Strong verbal and written communication skills.Premier Medical Group is an Equal Opportunity Employer