Prior Authorization Representative
Offer summary
Qualifications:
Previous experience in healthcare or health insurance is required., Knowledge of prior authorization processes and common medical procedures is essential., Exceptional verbal and written communication skills are necessary., A bachelor's degree in a related field is preferred, or equivalent experience..Key responsibilities:
- Evaluate medical documentation to determine prior authorization eligibility based on established criteria.
- Collaborate with healthcare providers to gather additional information when necessary.
- Serve as a point of contact for patients, explaining the prior authorization process and addressing their inquiries.
- Prepare and submit prior authorization requests, including all required documentation.
Job description
This is a remote position.
We are in search of a highly organized and detail-oriented Prior Authorization Representative to join our team. As a prior authorization representative, you will play a crucial role in our healthcare organization, ensuring that our patients receive necessary procedures and treatments efficiently and seamlessly. If you have experience in the healthcare or health insurance field and are ready to take on a challenging and rewarding role, we invite you to apply.
Responsibilities:
- Follow the company's values, vision, and mission.
- Evaluate medical documentation to determine prior authorization eligibility based on established criteria.
- Collaborate with healthcare providers to gather additional information when necessary.
- Serve as a point of contact for patients, explaining the prior authorization process and addressing their inquiries.
- Verify patient eligibility in accordance with insurance policy terms.
- Prepare and submit prior authorization requests, including all required documentation.
- Follow up on requests and resolve any issues that may arise during the process.
- Collaborate with other internal departments to ensure efficient coordination in prior authorization management.
- Maintain detailed records of all requests and related communications.
- Other duties as required.
Requirements
Qualifications:
- Previous experience in the healthcare field, health insurance, or similar administrative roles.
- Knowledge of prior authorization processes and common medical procedures.
- Exceptional communication skills, both verbal and written.
- Ability to work independently and as part of a team.
- Excellent organizational skills and attention to detail.
- Proficiency in office software and tools, such as Microsoft Office.
- Willingness to learn and adapt to changes in prior authorization policies and procedures.
Requirements:
- Bachelor's degree in related fields is preferred, or equivalent experience.
- Excellent verbal and written communication skills in English.
- Relevant certifications or licenses in the healthcare field are a plus.
- Availability to work flexible hours as required by the job.
- Commitment to maintaining patient information confidentiality and compliance with healthcare privacy regulations.
- Ability to adapt to changing priorities and work well under deadlines.
Benefits
Required profile
Experience
Other Skills
- Organizational Skills
- Communication
- Collaboration
- Customer Service
- Detail Oriented
- Teamwork
- Adaptability
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