Prior Authorization Specialist

Job Overview
We are seeking a proactive and detail-oriented Prior Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing the authorization process for medical varicose vein clinic, ensuring timely approvals that facilitate seamless patient care. Your expertise in managed care policies, medical terminology, and insurance procedures will drive efficiency and accuracy in processing prior authorizations. This position offers an exciting opportunity to contribute to a dynamic healthcare environment where your skills directly impact patient outcomes and provider satisfaction.

Responsibilities

• Review and evaluate prior authorization requests for varicose vein treatments, ensuring all documentation complies with insurance requirements and clinical guidelines
• Communicate effectively with healthcare providers, insurance companies, and patients to gather necessary information and clarify authorization statuses
• Verify insurance coverage, eligibility, and benefits using insurance verification tools and systems
• Maintain detailed records of authorization requests, approvals, denials, and related correspondence in accordance with HIPAA regulations
• Utilize CPT coding, ICD-9, ICD-10, and ICD coding standards to accurately document procedures and diagnoses for authorization purposes
• Collaborate with medical office staff to facilitate smooth workflow and timely processing of authorizations
• Stay updated on managed care policies, insurance plan changes, and coding updates to ensure compliance and accuracy

Requirements

• Proven experience in managed care environments or medical office settings with a focus on prior authorizations
• Strong knowledge of medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10 codes
• Familiarity with HIPAA regulations to ensure patient confidentiality and data security
• Experience with insurance verification processes within healthcare VARICOSE VEIN TREATMENT AUTHORIZATONS SUCH AS ABLATION, VARITHENA AND SCLEROTHERAPY PROCEDURES
• Excellent communication skills for liaising between providers, insurers, and patients
• Office experience with proficiency in electronic health records (EHR) systems or similar software
• Knowledge of medical billing procedures and familiarity with medical records management is a plus

Join us to be part of a dedicated team committed to delivering exceptional patient care through efficient authorization processes. Your expertise will help streamline operations while supporting the health and well-being of our patients.

Pay: $25.00 - $29.00 per hour

Work Location: In person