Bilingual Prior Authorization Specialist

Kintegra Health • Gastonia, NC

1d

About The Position

Under the direct supervision of the Customer Care Manager, the Prior Authorization Specialist is responsible for obtaining pre-authorizations for medications and diagnostics, scheduling patients for outpatient testing and coordinating patient orders.

Requirements

• None
• High School Diploma Required
• Previous experience in a clinic setting preferred.
• Must have excellent verbal and written communication skills.
• Requires effective customer relation skills, ability to organize and interpret data.
• Requires good judgment, tact, diplomacy, and ability to problem solve.
• Able to work effectively in a team environment.
• Able to use a personal computer and related software.
• Bilingual (English/Spanish).
• Must be able to sit, stand and walk for long periods of time.
• Able to read and understand the English language.
• Able to read and understand the Spanish language.
• Able to effectively maintain confidentiality of records and communicate with all levels of personnel.

Responsibilities

• Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
• Request, track and obtain prior authorization from insurance carriers within time allotted for medical services.
• Request, follow up and secure prior authorizations prior to services being performed.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Communicate any insurance changes or trends among team.
• Maintains a level of productivity suitable for the department.
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees