Prior Authorization Specialist

• Obtain prior authorizations for facility and professional charges following departmental protocols.
• Submit CPT and HCPCS codes and medical records to insurers to expedite authorizations.
• Verify patient demographics and medical details, ensuring HIPAA compliance.
• Review and confirm all supporting documents and collaborate with necessary stakeholders.
• Prioritize authorization requests and ensure the accuracy of CPT and ICD-10 codes.
• Maintain intranet resources related to payer requirements for prior authorizations.
• Notify patients or clinics if authorization is not secured before service dates.
• Handle retro authorizations, resolve denials, and manage appeals as needed.
• Track all actions and update patient accounts accurately.
• Communicate issues like billing concerns, backlogs, and documentation needs to leadership.
• Adapt to changing circumstances to support patient flow.
• Maintain professionalism, integrity, and confidentiality in all interactions.

Prior Authorization Specialist ensuring efficient prior authorization process for healthcare claims

Prior Authorization Specialist at Logan Health ensuring smooth prior authorization process for healthcare claims. Collaborating with teams to expedite insurance authorizations and maintain HIPAA compliance.

Prior Authorization Specialist jobs in Tennessee

See all jobs on JobTailor

Prior Authorization Specialist