Job Description

Overview
Under the direct supervision of the Customer Care Manager , the Prior Authorization Specialist is responsible for obtaining pre-authorizations for medications and diagnostics, scheduling patients for outpatient testing and coordinating patient orders.
Candidate Qualifications
Licensure/Certification: None
Education: High School Diploma Required
Experience: Previous experience in a clinic setting preferred.
Knowledge/Skills: Must have excellent verbal and written communication skills. Requires effective customer relation skills, ability to organize and interpret data. Requires good judgment, tact, diplomacy, and ability to problem solve. Able to work effectively in a team environment. Able to use a personal computer and related software.
Minimum Qualifications: Must be able to sit, stand and walk for long periods of time. Able to read and understand the English language. Able to effectively maintain confidentiality of records and communicate with all levels of personnel.
Job Responsibilities
Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
Request, track and obtain prior authorization from insurance carriers within time allotted for medical services.
Request, follow up and secure prior authorizations prior to services being performed.
Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
Communicate any insurance changes or trends among team.
Maintains a level of productivity suitable for the department.
Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
Other duties as assigned.
Kintegra Health Core Requirements
Patient First – An approach to care that holds primary, the well-being and desires of the patient
Build not Blame – Focusing first on finding fault with the process rather than the person
Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers
C ooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description
Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.

Job Tags

Work at office,

Similar Jobs

Innovative Consulting Inc (ICI)

Automation PLC Engineer Job at Innovative Consulting Inc (ICI)

...relevant engineering experience in the Pharmaceutical or Chemical industry Hands-on experience in configuring and troubleshooting PLC & HMI systems (Rockwell, Siemens). Solid understanding of Computer System Validation (CSV) for qualifying automation systems. In...

Diversified Transfer and Storage, Inc.

Class A Class A OTR Truck Driver Job Job at Diversified Transfer and Storage, Inc.

Class A Class A OTR Truck Driver JobLTL OTR refrigerated dedicated routes.Pay: $70,000 to $110,000Health, 401K, paid vacation, performance incentives.How to apply for this Driving JobFill out a Gary's Job Board application. That same application can be used to...

Farm Job Search

Dairy Herdsman / Farm Worker Job at Farm Job Search

...Dairy Herdsman / Farm Worker (5948) Location: Illinois JobNumber: 5948 Herdsman/Farm Worker Position available on an expanding 350 cow, clean, modern dairy farm in South Central Illinois. Farm also grows corn, soybeans, wheat and hay. Must have experience with...

Safelite

Auto Glass Installation Technician Trainee Job at Safelite

...fulfilling career and encourage you to have a life. Let us be the best place you'll ever work. A Brief Overview A Technician Trainee will be trained and educated to become a proficient auto glass technician. Upon completing our training program, the trainee will...

Casco Construction Corp

Residential Construction Project Coordinator Job at Casco Construction Corp

..., contract preparation and execution, develop and manage projects in Buildertrend, organize and maintain project documentation, subcontractor and vendor coordination, field support and project close-out support Casco Construction Corp. employs a terrific team comprised...

Prior Authorization Specialist Job at Kintegra Health, Gastonia, NC

cVM0bUhyekpFR0lWUGlxMG5jTU92SURUbEE9PQ==