Prior Authorization Specialist

Responsible for preparing charges for entry into the e-Clinical billing system for all physician practices as well as ensuring accuracy and verification of charge component levels prior to passing of charges. You will also be responsible for resolution of charges associated with assigned practices within an established time frame. Other office work can be assigned.

• Analyze insurance policies to determine which medical services, procedures, or medications require prior authorization.
• Prepare and submit requests for prior authorization to insurance companies.
• Act as a liaison between healthcare providers, patients, and insurance companies,.
• Follow up on prior authorization requests, address any issues or additional information requests, and negotiate for approval.
• Inform patients and healthcare providers of the approval or denial of prior authorization requests.

• High school degree or equivalent
• Associates degree in a business field
• Previous experience in a medical office setting
• Billing Experience; Typing and computer skills
• Customer Service skills