Prior Authorization Specialist (Transcranial Magnetic Stimulation)

Job Overview
The Prior Authorization Specialist plays a crucial role in the healthcare system by ensuring that patients receive the necessary approvals for medical services and procedures before they are performed. This position requires a detail-oriented individual who can navigate complex insurance requirements and communicate effectively with healthcare providers, patients, and insurance companies. The ideal candidate will have a strong background in managed care, medical office operations, and coding practices.

This position is a per diem job with varying hours to complete prior authorizations for Transcranial Magnetic Stimulation through insurances in the state of New Hampshire.

Duties

• Review and process prior authorization requests for TMS services.
• Verify patient insurance coverage and eligibility for requested services.
• Communicate with healthcare providers to gather necessary documentation and clarify any discrepancies.
• Ensure compliance with HIPAA regulations while handling sensitive patient information.
• Utilize CPT coding, ICD-9, and ICD-10 coding systems to accurately document medical necessity.
• Maintain organized medical records and documentation for all prior authorization requests.
• Collaborate with insurance companies to obtain approvals or denials of requests in a timely manner.
• Provide updates to patients regarding their authorization status and next steps.

Skills

• Proficient in managed care processes and insurance verification.
• Strong medical office experience with familiarity in handling patient records.
• Knowledge of HIPAA regulations to ensure confidentiality of patient information.
• Experience with CPT coding, ICD coding (ICD-9 & ICD-10), and medical terminology.
• Ability to effectively communicate with healthcare professionals, patients, and insurance representatives.
• Detail-oriented with excellent organizational skills to manage multiple requests simultaneously.

Job Type: Part-time

Pay: $25.00 per hour

Benefits:

• Flexible schedule

Application Question(s):

• How do you go above and beyond as an employee?
• What is your past experience with prior authorizations?

Education:

• High school or equivalent (Required)

Experience:

• prior authorization: 1 year (Required)

Location:

• New Hampshire (Required)

Work Location: Remote