Insurance Pre-Authorization Specialist-Ortho
About The Position
The Insurance Pre-Authorization Specialist is responsible for processing submissions for insurance prior authorizations (PA) and coordinating any denials follow up, as indicated. This role involves analyzing information required to complete pre-authorizations with insurance carriers and governmental payors, obtaining necessary information to accurately process requests, and utilizing third-party payer/insurance portals. The specialist will advocate for patients/providers by processing PA's in a time-sensitive manner and collaborating with physicians and nurses to secure clinical information. Additionally, the role includes cross-training to support office/scheduling functions and coordinating denial follow-up and processing FMLA/Disability Paperwork.
Requirements
- Health insurance work experience.
Responsibilities
- Analyzes information required to complete pre-authorizations with insurance carriers and governmental payors.
- Obtains necessary information to accurately process pre-authorization requests.
- Utilizes third party payer/insurance portals to process PA submissions; has a detailed knowledge of insurance providers, their portals and their expectations for authorization approval.
- Advocates for patients/providers by processing PA's in a time sensitive manner and collaborating, as indicated with physicians and nurses, to accurately secure clinical information to support the PA submission.
- Cross-trains to support additional office/scheduling functions as deemed necessary for optimal business operations.
- Coordinates any denial follow-up, as indicated.
- Process FMLA/Disability Paperwork.
Benefits
- Comprehensive benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
1-10 employees
