Prior Authorization Representative (Remote)

Envision Radiology•Colorado Springs, CO

2h•Remote

About The Position

The Prior Authorization Representative supports the Centralized Services Department by performing all tasks required to obtain referrals/authorizations and verifying patients’ insurance coverage under the direction of the Centralized Services Supervisor. This role involves notifying insurance companies of services, obtaining necessary authorizations, verifying patient insurance coverage, and ensuring all payer-specific authorization requirements are met while consistently meeting department productivity standards. The representative will also provide quality customer service, interface with provider’s offices and medical staff to gather documentation, and accurately record all actions in the Electronic Medical Record (EMR) system. The position also includes participation in peer-to-peer learning and development.

Requirements

One plus year of experience in healthcare pre-authorizations
Familiarity with ICD-10 and CPT coding
Detail oriented, self-motivated, a problem solver and a team player
Ability to navigate multiple computer screens and browsers quickly and accurately
Ability to excel in a very fast-pace team environment
Ability to continuously “exceed” company and customer expectation
Strong communication skills & professional demeanor
Minimum of High School diploma or equivalent (GED)

Nice To Haves

continuing education preferred

Responsibilities

Notifies insurance companies of services being rendered, and obtains any necessary authorizations, ensuring notification and verification is complete for each order.
Obtains and verifies any necessary additional demographic and/or billing information.
Assists in identifying authorization issues and ensures that insurance information has been accurately obtained.
Works daily queues according to department directives to ensure all payer-specific authorization requirements are met and authorizations successfully obtained while consistently meeting department productivity standards.
Provides quality customer service to all patients and customers through prompt and courteous professional communication.
Interfaces with provider’s offices and medical staff to ensure all necessary documentation is obtained for purposes of pursuing a successful authorization approval.
Documents accurately into the Electronic Medical Record (EMR) system all actions, interactions, and authorizations surrounding the insurance process for each patient.
Participates in peer-to-peer learning and development.
Other duties as assigned.