Soni Resources
A well established Medical Office is seeking a detail-oriented
Prior Authorization Specialist
to join their healthcare team! In this role, you will play a vital part in ensuring timely and accurate insurance authorizations for patient services. You will work collaboratively with medical providers and insurance carriers to facilitate efficient care delivery.
Responsibilities:
Obtain and verify patient insurance benefit coverage using insurance websites or by contacting carriers. Request, track, and obtain pre-authorizations for medical services within designated timeframes. Process referrals and submit medical records to expedite authorizations. Demonstrate knowledge of medical terminology and office procedures, including HIPAA regulations. Communicate insurance changes or trends within the team. Maintain productivity standards for the department. Document all communications and contacts with providers and personnel in standardized formats. Review the accuracy and completeness of requested information and ensure supporting documents are present. Review denials and follow up with providers to obtain necessary information for appeals. Prioritize incoming authorizations based on urgency. Communicate with medical providers and staff about patient concerns or issues related to verification. Requirements:
High School Diploma or equivalent. Two years of experience in a healthcare environment. Knowledge of Out-of-Network providers is highly preferred. Experience with insurance authorizations is preferred. Excellent verbal and written communication skills. Strong organizational and business office skills. Goal-oriented and detail-oriented with the ability to work in a fast-paced environment. Knowledge of medical terminology. Ability to build and maintain relationships with insurance representatives. Ability to work effectively with physicians and other medical staff. Commitment to maintaining patient and company confidentiality.
Compensation:
$21-$25/ Hour Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.
#SONICNJ
Prior Authorization Specialist
to join their healthcare team! In this role, you will play a vital part in ensuring timely and accurate insurance authorizations for patient services. You will work collaboratively with medical providers and insurance carriers to facilitate efficient care delivery.
Responsibilities:
Obtain and verify patient insurance benefit coverage using insurance websites or by contacting carriers. Request, track, and obtain pre-authorizations for medical services within designated timeframes. Process referrals and submit medical records to expedite authorizations. Demonstrate knowledge of medical terminology and office procedures, including HIPAA regulations. Communicate insurance changes or trends within the team. Maintain productivity standards for the department. Document all communications and contacts with providers and personnel in standardized formats. Review the accuracy and completeness of requested information and ensure supporting documents are present. Review denials and follow up with providers to obtain necessary information for appeals. Prioritize incoming authorizations based on urgency. Communicate with medical providers and staff about patient concerns or issues related to verification. Requirements:
High School Diploma or equivalent. Two years of experience in a healthcare environment. Knowledge of Out-of-Network providers is highly preferred. Experience with insurance authorizations is preferred. Excellent verbal and written communication skills. Strong organizational and business office skills. Goal-oriented and detail-oriented with the ability to work in a fast-paced environment. Knowledge of medical terminology. Ability to build and maintain relationships with insurance representatives. Ability to work effectively with physicians and other medical staff. Commitment to maintaining patient and company confidentiality.
Compensation:
$21-$25/ Hour Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.
#SONICNJ