Prior Authorization Specialist

Responsibilities

Efficiently handle authorization and billing-related tasks to ensure timely processing.

Receive and resolve inquiries from patients and insurance providers with professionalism and accuracy.

Conduct calls to insurance providers to obtain necessary information and follow up on authorization requests.

Deliver exemplary customer service by addressing and resolving issues promptly, particularly when interacting with Workers Compensation Adjusters and Insurance Representatives.

Work collaboratively with Workers Compensation Adjusters to negotiate pricing and ensure fair compensation for services.

Complete and submit all necessary authorization forms accurately and in a timely manner.

Utilize the Brightree system for tracking and managing authorization requests.

Develop expertise in relevant data systems to facilitate efficient research and data retrieval.

Uphold confidentiality and ensure compliance with all legal and regulatory requirements, including HIPAA.

Complete all assigned training within specified timeframes to stay current with policies and procedures.

Qualifications and Requirements

Ability to multitask effectively while managing various scenarios and researching patient records.

Meticulous attention to detail is required to ensure accuracy in processing requests and documentation.

Has a friendly and outgoing demeanor with strong organizational skills and proficiency in general office tasks.

Clear and coherent in both verbal and written communication skills, with the ability to convey complex information clearly and professionally.

Strong problem-solving abilities, with the capacity to interpret information accurately and respond promptly to issues.

Willingness to take on additional responsibilities as needed within and across departments.

Responsibilities

Efficiently handle authorization and billing-related tasks to ensure timely processing.

Receive and resolve inquiries from patients and insurance providers with professionalism and accuracy.

Conduct calls to insurance providers to obtain necessary information and follow up on authorization requests.

Deliver exemplary customer service by addressing and resolving issues promptly, particularly when interacting with Workers Compensation Adjusters and Insurance Representatives.

Work collaboratively with Workers Compensation Adjusters to negotiate pricing and ensure fair compensation for services.

Complete and submit all necessary authorization forms accurately and in a timely manner.

Utilize the Brightree system for tracking and managing authorization requests.

Develop expertise in relevant data systems to facilitate efficient research and data retrieval.

Uphold confidentiality and ensure compliance with all legal and regulatory requirements, including HIPAA.

Complete all assigned training within specified timeframes to stay current with policies and procedures.

Qualifications and Requirements

Ability to multitask effectively while managing various scenarios and researching patient records.

Meticulous attention to detail is required to ensure accuracy in processing requests and documentation.

Has a friendly and outgoing demeanor with strong organizational skills and proficiency in general office tasks.

Clear and coherent in both verbal and written communication skills, with the ability to convey complex information clearly and professionally.

Strong problem-solving abilities, with the capacity to interpret information accurately and respond promptly to issues.

Willingness to take on additional responsibilities as needed within and across departments.