Prior Authorization Representative
Granite Peaks GI, LLC Granite Peaks GI, LLC Sandy, UT Sandy, UT Full-time Full-time $18.
50 - $19.
50 an hour $18.
50 - $19.
50 an hour 1 day ago 1 day ago 1 day ago The Prior Authorization Representative is responsible to secure outpatient prior authorization before services are rendered.
This position will work with physicians, nurses, clinic managers, and Billing representatives to resolve issues that arise during the prior authorization process.
Responsibilities:
- Reviews and summarizes pre-authorization criteria for medical necessity to aid departments with procedure scheduling.
- Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
- Requires critical thinking to determine what each individual payer requires to authorize the visit.
- Acts as a liaison between the payer and clinic schedulers/medical support staff - Maintaining email resource and internal log and working closely with supervisors and managers.
- Ability to work many different insurance websites with precision and accuracy.
- Follows up on delayed or denied authorization requests and escalates for resolution.
Facilitates provider and insurance medical reviews for medical determination if the visit should require reconsideration for prior authorization - Creates and maintains detailed documentation of the authorization/notification trail.
- Meets productivity and accuracy expectations of the position.
- Other duties as required.
Problem Solving Demonstrated ability to provide clear and professional written/verbal communication skills.
Ability to meet deadlines for projects, tasks, and goals as assigned.
Ability to organize and prioritize work to meet productivity expectations.
Ability to provide professional and courteous service in all interactions with internal and external customers.
Demonstrated ability to complete work with a high level of detail and accuracy.
Demonstrated accountability for work taking ownership for quality and timeliness of work.
Ability to work independently within a team setting.
Consistently demonstrates positive attitude when interacting with team members.
Ability to resolve difficult or complicated challenges in a logical manner and provide recommendations for resolution.
Ability to prioritize and multitask.
Minimum Qualifications 1
year experience in healthcare financial setting, or the equivalency.
Required 1
year experience with insurance and prior authorizations.
Required Job Type:
Full-time Pay:
$18.
50 - $19.
50 per hour Expected hours:
36 per week
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance Weekly day range:
Monday to Friday
Experience:
Insurance verification:
1 year (Preferred) Medical billing:
1 year (Preferred) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
50 - $19.
50 an hour $18.
50 - $19.
50 an hour 1 day ago 1 day ago 1 day ago The Prior Authorization Representative is responsible to secure outpatient prior authorization before services are rendered.
This position will work with physicians, nurses, clinic managers, and Billing representatives to resolve issues that arise during the prior authorization process.
Responsibilities:
- Reviews and summarizes pre-authorization criteria for medical necessity to aid departments with procedure scheduling.
- Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
- Requires critical thinking to determine what each individual payer requires to authorize the visit.
- Acts as a liaison between the payer and clinic schedulers/medical support staff - Maintaining email resource and internal log and working closely with supervisors and managers.
- Ability to work many different insurance websites with precision and accuracy.
- Follows up on delayed or denied authorization requests and escalates for resolution.
Facilitates provider and insurance medical reviews for medical determination if the visit should require reconsideration for prior authorization - Creates and maintains detailed documentation of the authorization/notification trail.
- Meets productivity and accuracy expectations of the position.
- Other duties as required.
Problem Solving Demonstrated ability to provide clear and professional written/verbal communication skills.
Ability to meet deadlines for projects, tasks, and goals as assigned.
Ability to organize and prioritize work to meet productivity expectations.
Ability to provide professional and courteous service in all interactions with internal and external customers.
Demonstrated ability to complete work with a high level of detail and accuracy.
Demonstrated accountability for work taking ownership for quality and timeliness of work.
Ability to work independently within a team setting.
Consistently demonstrates positive attitude when interacting with team members.
Ability to resolve difficult or complicated challenges in a logical manner and provide recommendations for resolution.
Ability to prioritize and multitask.
Minimum Qualifications 1
year experience in healthcare financial setting, or the equivalency.
Required 1
year experience with insurance and prior authorizations.
Required Job Type:
Full-time Pay:
$18.
50 - $19.
50 per hour Expected hours:
36 per week
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance Weekly day range:
Monday to Friday
Experience:
Insurance verification:
1 year (Preferred) Medical billing:
1 year (Preferred) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
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