Prior Authorization Specialist
About The Position
The Prior Authorization Specialist is responsible for all aspects of the prior authorization process. This includes collecting necessary documentation, contacting clients for additional information, and completing required prior authorizations to proceed with testing. The role involves the complete, timely, and accurate identification and submission of prior and retro authorization requests to payors. The specialist will interact with clients, insurance companies, patients, and sales representatives to request prior authorizations. Key responsibilities also include documenting account activity, updating patient and claim information, demonstrating proficiency with the XIFIN billing system for efficient claim processing, and identifying prior authorization trends or issues that cause delayed claims. The position requires providing the highest level of customer service to both internal and external clients.
Requirements
- Minimum 2 years of customer service experience in the healthcare industry
- High level of accuracy
- Attention to detail
- Ability to prioritize and meet defined deadlines
- The ability to organize systematic paper and electronic files
- The ability to work in a fast-paced team environment
Nice To Haves
- Proficiency in the XIFIN system is preferred
- Proficiency in the Glidian system is preferred
Responsibilities
- Responsible for all aspects of the prior authorization process
- Collecting all the necessary documentation
- Contacting the client for additional information and completion of the required prior authorization in order to proceed with testing
- Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors
- Interacts with clients, insurance companies, patients, and sales representatives, as necessary, to request for prior authorizations
- Responsible for documenting account activity
- Updating patient and claim information
- Demonstrates proficiencies with the XIFIN billing system to ensure all functionalities are utilized for the most efficient processing of claims
- Identifies prior authorization trends and/or issues resulting in delayed claims processing
- Provides the highest level of customer service to internal and external clients
Benefits
- Comprehensive compensation and benefits package
- Competitive salary
- Company paid medical insurance coverage
- Company paid dental insurance coverage
- Company paid vision insurance coverage
- Company paid life insurance coverage
- 401(k) with company match
- Generous employee discounts
- Casual, but driven work environment
- Ability to make a real difference as a key contributor to our growth
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
101-250 employees
