Prior Authorization Specialist

North Florida Surgeons•Jacksonville, FL

About The Position

The prior authorization specialist will assist patients who need treatment requiring insurance carrier pre-authorization. They interview patients to assess their medication needs and liaise with insurance companies and nurse managers for prior authorization approval. Duties/Responsibilities: Accurately carries out the responsibility for verifying patient insurance coverage, and ensures that necessary visits and procedures are covered by an individual’s provider. Responsible for entering data in an accurate manner, updating patient benefit information and verifying that existing information is accurate. Demonstrates proficiency in working with insurance companies, and has extensive knowledge of different types of coverage and policies. Demonstrates excellent multitasking skills, with the ability to work on many projects at once. Is very detail-oriented and organized, and maintains accurate patient insurance records. Possesses the ability to focus and work quickly. Ensuring that paperwork is processed in a timely manner. Serves as a trusted resource to patients, providing them with pertinent information regarding their coverage. Uses good judgement in contacting the patient for discovered unforeseen issues (i.e. anticipated procedure not covered, large co-pay or co-insurance, patient’s insurance premium was not paid) Utilizes patient chart on an as needed basis, accessing only information related to treatment, payment, and health operations. Comply with HIPPA confidentiality standards when accessing or communicating patient information Other duties as assigned by supervisor, manager or physician

Requirements

Excellent verbal and written communication skills
Ability to interact with patients and employees in a courteous, professional manner at all times
Excellent organizational skills and attention to detail
Ability to multi-task and function well in a high-paced and at times stressful environment
High School Diploma or equivalent

Nice To Haves

Healthcare receptionist experience preferred

Responsibilities

Verifying patient insurance coverage
Entering data in an accurate manner
Updating patient benefit information
Working with insurance companies
Maintaining accurate patient insurance records
Processing paperwork in a timely manner
Providing patients with information regarding their coverage
Contacting the patient for discovered unforeseen issues
Utilizing patient chart on an as needed basis
Complying with HIPPA confidentiality standards when accessing or communicating patient information
Other duties as assigned by supervisor, manager or physician