We are hiring a Prior Authorization Specialist with a background in healthcare, AR calling, and prior authorization processes. The ideal candidate will be responsible for reviewing authorization requests, verifying patient eligibility, and ensuring compliance with medical guidelines.
Roles & Responsibilities:
- Process and review prior authorization requests for medical services and prescriptions.
- Verify patient eligibility, benefits, and coverage.
- Analyze clinical information to determine medical necessity as per guidelines.
- Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and resolve issues.
- Maintain accurate documentation of all authorization requests and approvals.
- Ensure compliance with healthcare regulations and meet productivity and quality benchmarks.
Desired Candidate Profile:
- Minimum 1+ year of experience in prior authorization, AR calling, or healthcare services.
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal abilities.
- Ability to handle high call volumes (10+ calls per day) in a fast-paced environment.
- Knowledge of medical terminology and healthcare regulations.
If you have the required expertise and are looking for a challenging yet rewarding role, apply today!
