Overview
Prior Authorization Specialist – Onsite Jobs in Festus – Missouri – USA at PainPoint Health
Job Description
Job Description
Job description
We are currently seeking a remote Prior Authorization Coordinator. This individual will be responsible for all aspects of the prior authorization process for interventional pain management procedures in an office or outpatient setting including advanced procedures.
Your responsibilities will include:
Monitor Advanced procedure trackers for each practice and identify opportunities to assist with the authorization process.
Collecting all the necessary documentation to obtain prior authorization.
Review medical necessity guidelines for all procedures by payor
Contacting the practice for additional information and completion of the required prior authorization in order to proceed with procedures and medication requests
Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors
Interacts with pain practices, vendors, insurance companies, patients, and management, as necessary, to request for prior authorizations
Responsible for documenting account activity, updating patient and claim information and demonstrating proficiencies with the prior authorization system to ensure all functionalities are utilized for the most efficient processing of claims
Identifies prior authorization trends and/or issues resulting in delayed claims processing.
Provides the highest level of customer service to internal staff
Serves as a backup to the Contact Center Team to receive inbound calls for patient scheduling as needed during peak hours of high call volume
Compensation Package
Performance-based bonus incentives
Ability towork from home(remotely)
A wide range of benefits includingpaid time off(PTO), 401k, medical, dental, vision insurance, and more
Respectand value ofdiversity, integrity, andteamwork
General Duties
Prior Authorization:
Notify the provider offices on any delays with pending prior authorizations
Coordinate with the provider offices on any items needed to submit a timely prior authorization
Status pending prior authorizations (electronically or via phone call)
Submit prior authorizations in the approved system
Input prior authorization number into the EMR per policy
Coordinate STAT or urgent prior authorization with the provider office
Contact Center Team:
Respond to patients via telephone by assessing needs and answering general questions regarding treatment options
Register and schedule new patients; send appropriate patient materials prior to initial appointment
Make appropriate scheduling changes, canceling, rescheduling and confirming appointments
Provide excellent and timely customer service
Maintain operations by following policies and procedures
Taking inbound calls to schedule new and existing patients for an assigned practice
Requirements
High School diploma/GED required
Proficiency with basic computer functions including mouse and keyboard usage, launching applications, conducting searches on the Internet, and maneuvering in a Windows-based environment strongly preferred
Collaborative- You appreciate direct coaching/feedback to identify your strengths and opportunities for improvement
At least one (1) year of Prior Authorization experience is required
Basic understanding of medical terminology (1) year in a clinical setting
Familiar with navigating payor portals to obtain authorization and medical policies
Strong organizational skills
Job Type:Full-time
Pay:$17…
Title: Prior Authorization Specialist – Onsite
Company: PainPoint Health
Location: Festus – Missouri – USA
Category: Healthcare, Administrative/Clerical
