Authorization/Precert Specialist

Responsibilities

• Obtain prior authorizations and precertifications for surgical procedures, MRIs, injections, and other services.
• Communicate with insurance carriers to provide documentation and information needed for authorization approval.
• Utilize online insurance portals to submit and track authorization requests.
• Gather and verify patient demographic and insurance information.
• Cook up coordination with physicians regarding peer-to-peer reviews and authorization requirements.
• Communicate professionally with patients, providers, and staff regarding authorization status and next steps.
• Respond to inquiries from outside organizations regarding patient care and authorization needs.
• Verify patient eligibility and relay updates or changes to appropriate staff.
• Maintain clear, accurate, and concise documentation within the system.
• Manage multiple priorities while maintaining an organized workflow.
• Stay current on assigned work queues and authorization cases.
• Perform other duties as assigned.

Qualifications

• Previous EPIC Experience is required.
• Minimum of 2 years of medical prior authorization/precertification experience.
• Experience obtaining authorizations for surgeries, MRIs, injections, or related services.
• Orthopedic authorization experience preferred.
• Strong attention to detail and organizational skills.
• Ability to work independently and manage multiple priorities.
• Excellent verbal and written communication skills.
• Professional, patient-focused approach to customer service.
• High School Diploma or GED required.

Schedule

Full-Time
Hybrid work model
Location: Farmington, CT
Can start your day as early as 7:30 AM and finish as late as 6:00 PM (within a 40 hour window)

Pay Rate

$23 - $25.50 per hour (based on experience)

Benefits

• Hybrid Work Opportunity!
• PTO 13 Days on an accrual basis.
• Very nice office and kitchen space, recently moved to a new building.
• 401K 3% match.
• Full benefits.
• Excellent Workplace Environment.