A Prior Authorization (PA) job involves securing insurance approval for medical services, medications, or equipment before they're provided, requiring review of patient records, verifying insurance, submitting detailed requests, tracking approvals/denials, appealing rejections, and communicating with providers and patients, ensuring timely patient care and revenue cycle efficiency. Key duties include data entry, follow-ups, ensuring medical necessity documentation, and handling administrative tasks related to payer policies.
Key Responsibilities:
Essential Skills:
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Attention to detail
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Strong communication
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Knowledge of medical terminology/coding (often preferred)
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Problem-solving
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Organizational skills and ability to multitask