Pre-authorization Specialist
hace 2 meses
**Location**: Fully Remote (LatAm)
**Schedule**: CST
**Salary**: 1800 - 2000 USD/month
We are looking for a proactive and dynamic Pre-Authorization Specialist to join an esteemed medical group practice specializing in Interventional Pain Management, located in Morris, IL. With a commitment to delivering exceptional patient care, we are seeking an individual who can provide remote administrative support to our medical team, enhancing operational efficiency and patient satisfaction.
**Key Responsibilities**:
- Verifying medical insurance coverage
- Effectively navigate and manage tasks through insurance portals
- Understanding and determining the rules of medical necessity
- Processing prior authorization requests
- Ensuring accurate data entry
- Evaluating individual requests for coverage authorizations
- Understanding criteria prior to submitting
- Obtaining pre-approval from insurance companies for patient medications and treatments
- Communicating with patients, insurers, and other appropriate parties
- Reviewing and interpreting medical documents
**Requirements**:
- Bachelor's degree in healthcare administration, business administration, or related field preferred.
- Strong communication skills to effectively interact with patients, insurance companies, healthcare providers, and other relevant parties.
- Experience in verifying medical insurance coverage
- Ability to review and interpret medical documents
- Experience evaluating patient requests for coverage authorizations
- Strong understanding of ICD-10 and CPT coding systems for accurate medical billing and insurance claims
- Ability to efficiently use various insurance provider portals for submitting claims, reviewing coverage, and obtaining authorizations
- Excellent organizational skills, attention to detail, and ability to prioritize tasks effectively.
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