Prior Auth Specialist - Geneva Primary
About The Position
Under the direction and supervision of the Practice Manager, obtains approval from insurance companies (including all commercial plans, state plans, Workers Comp, and VA) for medical services, procedures, or medications by verifying coverage, collecting clinical and demographic information, and documenting all communication. Key responsibilities include managing the submission and tracking of authorization requests and denials, coordinating and scheduling patient appointments and procedures, acting as a liaison between providers and payers, and ensuring timely patient care and financial coverage.
Requirements
- High School or equivalent education.
- 1-2 years experience in a medical setting/environment
- Demonstrated ability to handle confidential information with discretion and ability to deal with the people in a professional and courteous manner.
- Ability to meet deadlines, manage multiple priorities and enhance the spirit of teamwork through effective role modeling.
- Excellent interpersonal, communication and organization skills.
- Computer literacy
Nice To Haves
- AAS degree in relevant field
- Prior scheduling experience
- Experience with Microsoft Office products and electronic scheduling system
Responsibilities
- Managing the submission and tracking of authorization requests for medical services, procedures, and medications for all insurance plans, including; commercial, state plans, Workers Comp, and VA.
- Collects and accurately document demographics, clinical, and insurance details. Confirm patient eligibility and benefits for proposed treatment
- Serve as a central point of contact between patients, healthcare providers, and insurance companies to facilitate the approval process.
- Maintains an extensive understanding of insurance plans and treatment criteria for services.
- Performs other duties as assigned.
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What This Job Offers
Job Type
Full-time
Industry
Ambulatory Health Care Services
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
