Job Description

Prior Authorization Specialist

Our client, a leading healthcare service provider specializing in cutting-edge technology to treat skin cancer, is seeking a detail-oriented and self-motivated Prior Authorization Specialist to join their Centralized Services Department. With partnerships with over 200 practices across the United States and generating over $70 million in revenue, the company is experiencing rapid growth, offering a tremendous opportunity for career development. This is a hybrid position, allowing you to work from home two days per week, along with amazing benefits.

The Prior Authorization Specialist plays a pivotal role in ensuring the successful delivery of cutting-edge skin cancer treatment by obtaining necessary authorizations under the guidance of the VOB Manager. This position offers an exciting opportunity to work with innovative technology and be part of a dynamic team.

Essential Functions:

1. Authorization Processing: Notify insurance companies of planned services and secure all necessary authorizations, ensuring complete verification for each order.
2. Authorization Issue Identification: Assist in identifying any authorization-related issues and ensure accurate insurance information has been obtained.
3. Daily Queues Management: Work according to department directives, efficiently managing daily queues to meet payer-specific authorization requirements and achieve successful authorizations while maintaining department productivity standards.
4. Customer Service: Provide exceptional customer service to all staff and medical practices through prompt and courteous professional communication.
5. Documentation and Communication: Interface with provider offices and medical staff to obtain all necessary documentation required for successful authorization approvals.
6. Problem Solving: Exhibit problem-solving skills to navigate challenges and ensure timely authorizations.

Job Qualifications:

Minimum Qualifications/Experience:

• Minimum of one year of experience in healthcare pre-authorizations.
• Familiarity with ICD-10 and CPT coding.
• Detail-oriented, self-motivated, and a team player.
• Proficient in navigating multiple computer screens and browsers quickly and accurately.
• Ability to excel in a fast-paced team environment and consistently exceed company and customer expectations.
• Strong communication skills and a professional demeanor.

Benefits:

• Tremendous opportunity for career growth in a rapidly expanding company.
• Hybrid work from home arrangement - two days per week.
• Competitive salary and benefits package, including medical, dental, and life insurance.

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