Role and Responsibilities
The Scheduler/Prior Authorization Specialist isresponsible for obtaining pre-authorizations from insurance carriers. Inputsthe data accurately and timely into the EMR software. Review daily schedules todetermine which payors require prior authorization. Review clinical datamatching it against specified medical terms and diagnoses or procedure codesand follow established procedure for authorization request. Knowledgeable inmedical terminology, CPT codes, ICD-10, NCCI edits and LCD policies.
Communicate with the schedulingdepartment to make sure they know when they are able to schedule patients.Contact patients to let them know if their insurance has denied theirauthorization request. Work directly with patients to have them assist withobtaining prior authorization from their insurance carrier when needed.
The position will also perform lightadministrative duties and any other tasks as assigned by the Scheduling Department Manager.
Qualifications and Education Requirements
Minimum two years’ experience in Medical Insurance billingexperience required.
Minimum ofone-year experience with prior authorization experience (healthcarepreferred).
Preferred Skills
- Computer skills including web browsing, excel, and EMR software
- Excellent verbal and written communication skills
- Knowledge of medical terminology, CPT codes and ICD-10
- Ability to analyze data given to provide the appropriate information to insurance companies
- Ability to respond to questions in a tactful and professional manner
- Excellent people skills; ability to work independently and as a team member
- Understanding of HIPPA regulations, respect for patient confidentiality
Efficiency and attention to detail'
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Work Location:
Work Remotely
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Weekly day range:
Experience:
- Medical Billing: 2 years (Preferred)
Work Location: In person