Prior Authorization Representative

TEKsystems•Des Moines, IA

1d•Onsite

About The Position

This position will be customer facing and working in the office to support patient referrals and prior authorizations. Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls. They may be responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and/or scheduling the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate Patients of their financial responsibility when applicable.

Requirements

Previous healthcare customer service experience required
Prior medical terminology experience required
Must have medical office experience

Responsibilities

Fast paced role working with doctors orders all day long - entering them in the system and making Medicare and insurance guidelines are followed.
Develop and maintain working knowledge of current products and services offered by the company
Answer all calls and emails in a timely manner, in adherence to their goals
Document all call information according to standard operating procedures
Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
Process orders, route calls to appropriate resource, and follow up on customer calls where necessary
Review all required documentation to ensure accuracy
Accurately process, verify, and/or submit documentation and orders
Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required