Insurance Authorization Specialist - III
Description:
• Responsible for obtaining authorizations for elective infusions and injections.
• Ensure reimbursement for the organization.
• Utilize payor resources to verify accurate prior authorization requirements.
• Escalate financial clearance risks as appropriate.
• Act as a liaison between clinical teams and pharmacists for communication regarding infusion prior authorization issues.
• Code cases and review clinical documentation for completeness.
Requirements:
• High school graduate or equivalent with 2 years working experience in a medical environment, (such as a hospital, doctor’s office, or ambulatory clinic.)
• Associate’s degree and 1 year of experience in a medical environment.
• 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
• Understanding of authorization processes, insurance guidelines, and third-party payors practices.
• Proficiency in Microsoft Office applications.
• Excellent communication and interpersonal skills.
• Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
• Basic computer skills.
Benefits:
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• Responsible for obtaining authorizations for elective infusions and injections.
• Ensure reimbursement for the organization.
• Utilize payor resources to verify accurate prior authorization requirements.
• Escalate financial clearance risks as appropriate.
• Act as a liaison between clinical teams and pharmacists for communication regarding infusion prior authorization issues.
• Code cases and review clinical documentation for completeness.
Requirements:
• High school graduate or equivalent with 2 years working experience in a medical environment, (such as a hospital, doctor’s office, or ambulatory clinic.)
• Associate’s degree and 1 year of experience in a medical environment.
• 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
• Understanding of authorization processes, insurance guidelines, and third-party payors practices.
• Proficiency in Microsoft Office applications.
• Excellent communication and interpersonal skills.
• Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
• Basic computer skills.
Benefits:
Apply Now
Apply Now