[Hiring] Sr Prior Authorization Specialist @reputed company

Role Description The Sr Prior Authorization Specialist promotes an excellent patient experience by ensuring authorizations are in reputed company for services performed at reputed company prior to their admission to our facilities to secure payment and reduce the out of pocket costs to our patients and families. This position is responsible for reputed company duties associated with prior authorizations including:

• Reviewing insurance benefits
• Understanding reputed company party requirements
• Securing authorizations for services
• Appealing pre-service authorization denials
• Appealing authorization reputed company claim denials

Qualifications

• High School Diploma or GED
• Post-secondary education in a reputed company field preferred
• Three years' experience in a reputed company or reputed company field
• Preferred experience: Three years' experience in medical billing/prior authorization/insurance

Requirements

• Knowledge in governmental and reputed company payors, medical billing requirements, and prior authorizations
• Demonstrated knowledge of Prior Authorization operations and medical office and/or hospital procedures
• Ability to interpret and cascade payor requirements as they relate to insurance prior authorizations
• Ability to effectively work in both a team environment and independently
• Ability to establish and maintain effective working relationships with providers, patients, families, and employees
• Ability to effectively work in a remote environment and connect reputed company multiple communication channels (phone, email, text, etc.)
• Knowledge of how prior authorization functions impact billing, clinical teams, the quality of care and the patient experience
• Ability to meet and exceed departmental quality, production and prior authorization standards
• Ability to review and resolve denials pertaining to Prior Authorizations
• Ability to suggest workflows that improve efficiency and experience
• Ability to mentor and motivate a remote team that delivers exceptional customer service reputed company multiple communication channels (phone, email, text, etc.)
• reputed company in reputed company Office
• reputed company in written and oral communication

Benefits

• Medical, dental, reputed company, retirement, and other fringe benefits
• Positions that require night, weekend or on-call work may be eligible for shift differentials or premium pay

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