Prior Authorization Coordinator_

Description:Works as a member of the Prior Authorization Operations team. Processes prior authorization requests in accordance with standards for accuracy, timeliness, productivity, and client performance commitments. Uses various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. Utilizes reasoning skills to identify missing information and interacts with internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality. Works under general supervision, relying on instructions, work process guidelines, policies & procedures, and company knowledge/experience to perform the functions of the job. Extent of supervision ranges from close, to moderate, to minimal oversight based upon demonstrated skill and performance levels as defined for the position. This position is part of a three-level career path with progression opportunities described in the Core Processing Career Path/Succession Planning Guidelines. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Review and process prior authorization requests from healthcare providers, ensuring accuracy and completeness of information. • Verify insurance coverage and eligibility for requested services. • Collaborate with healthcare providers, payers, and internal teams to gather necessary documentation and information for authorization submissions. • Navigate and adhere to guidelines as dictated by the client’s plan document, policies, and procedures related to prior authorization. • Communicate with healthcare providers regarding the status of prior authorization requests and address any additional information or documentation required. • Maintain detailed and accurate records of prior authorization activities, including tracking approvals and denials. • Stay updated on changes in healthcare regulations, policies, and procedures related to prior authorization. • Assist in the development and implementation of process improvements to enhance the efficiency of the prior authorization workflow. • Provide exceptional customer service to internal and external stakeholders, addressing inquiries and concerns in a timely and professional manner.Skills:prior authorization, health insuranceTop Skills Details:prior authorization,health insuranceAdditional Skills & Qualifications:data entry, attention to detailExperience Level:Entry LevelAbout TEKsystems:We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.