Prior Authorizations Specialist - OutpatientPulmonary
About The Position
The Prior Authorizations Specialist supports Hartford HealthCare Medical Group’s Pulmonary Sleep Centers by obtaining authorizations for home sleep testing (HST) and coordinating the testing process. The role includes managing test orders and work queues, verifying insurance eligibility and benefits, securing required authorizations and approvals, and coordinating patient appointments to pick up equipment. It also involves preparing and configuring HST devices, educating patients on their use, troubleshooting, uploading completed test data and reports, and routing results to the appropriate physician for scoring and interpretation. The specialist works with physicians when collected data is unsuccessful to determine whether a patient should repeat the test, and helps ensure efficient access, a positive patient experience, and high-quality diagnostic testing.
Requirements
- At least 1 year of experience as a medical receptionist or previous care coordination experience.
- Direct customer service experience in the medical field.
Responsibilities
- Manage work queues to ensure home sleep testing orders are processed properly and promptly.
- Obtain prior authorizations and insurance approvals; verify insurance eligibility, benefits, and copays.
- Schedule appointments for patients to pick up home sleep testing equipment.
- Prepare, configure, and assign home sleep testing units based on provider orders.
- Ensure devices are charged, calibrated, cleaned, and ready for use.
- Maintain inventory of sensors, belts, and device supplies.
- Provide patients with instructions and demonstrations on how to use testing equipment.
- Troubleshoot equipment or testing issues.
- Upload data for completed tests through the appropriate software and ensure reports are accurately uploaded and routed to the correct physician for scoring and interpretation.
- Collaborate with physicians about unsuccessful data collection to determine whether patients need to repeat testing.
Benefits
- Competitive benefits program designed to ensure work/life balance.
- Opportunities for career development and growth.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
