Prior Authorization Representative

Prior Authorization Representative Job Description Client Profile

• An Indiana based Independent Physician-Owned radiology practices founded in 1967 .

Job Summary

• Prior Authorization Representative is responsible for securing inpatient/outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorizations before service are rendered . Must be comfortable working with clinical professionals. Job Duties Verify insurance eligibility, benefits, network status and create pre-service liability estimate. Ensure accurate ICD, CPT codes and related medical records are submitted in the authorization request. Secure prior authorizations of inpatient and outpatient imaging. Acts as a liaison between the payer and clinic schedulers/medical support. Follows up on delayed or denied authorizations requests and escalates for resolution. Create detail documentation and maintain /stores the authorization paper trail.

Requirements

Qualifications

High School Diploma, 3+years of experience in a health care financial setting or medical office setting. Must have previous prior authorization experience. Excellent customer service skills, strong attention to details, multi-task as needed. Must be familiar with an EMR or HER; Microsoft Office 365 Must be able to take responsibility and work under pressure .

Work efficiently in a busy medical office. Must be a positive team player. K nowledge of ICD-10, CPT, and HCPCS codes specific to radiology is a plus. Proficient in medical terminology, especially radiological terms and procedures. Days/Hours: M/F 8a to 5pm (Availability to start as early as 7a and work as last as 6:00pm is a plus) Starting pay $2 0 .

00 to $2 1 .00 hourly (Based on experience)