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Natow Rosenberg & Pion MD PC

Prior authorization specialist

Natow Rosenberg & Pion MD PC, Woodmere, New York, United States, 11598

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Benefits:

Employee discounts

Flexible schedule

Free uniforms

Health insurance

Paid time off

Training & development

The Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by processing prescriptions, addressing and rectifying denials and conducting necessary third-party authorization requests and appeals.

Prior Authorization Specialist Primary Responsibilities:

Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.

Follow prior authorization workflow and policies and procedures.

Review the accuracy and completeness of information requested and ensure that all supporting documents are present.

Receive requests for prior authorizations and ensure that they are properly and closely monitored.

Process and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes.

Manage correspondence with insurance companies, physicians and patients as required.

Look through denials and submit appeals.

Document all prior authorization information including approval dates, prior authorization number in patient chart.

Proactively work on prior authorizations that are due to be expired.

Secure patients’ demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation

Coordinated medication deliveries

Prior Authorization Specialist Qualifications:

Excellent verbal, written and customer service skills

Ability to work independently, meet deadlines and be flexible

Good organizational skills and detail oriented

Knowledge of medical terminology (including sig codes and ICD-10), brand and generic names of medications and general medical terminology

Ability to perform tasks accurately and efficiently when inputting information

Work Experience

Required: 1+ years prior authorization experience

Desired: 3+ years prior authorization experience

Skills/Knowledge

Required: Prior authorization process, CoverMyMeds experience, knowledge/understanding of Medicare, Medicaid, and commercial insurance.

Behavior Competencies

Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills