Prior Authorization Specialist

About the role

The Prior Authorization Specialist supports high-quality patient care by ensuring timely insurance verification and authorization for scheduled services. This role serves as a key liaison between patients, physicians, insurance carriers, and hospital departments.

Responsibilities

• Serve as a key liaison between patients, physicians, insurance carriers, and hospital departments to facilitate accurate and efficient authorization processes.
• Ensure timely insurance verification and authorization for scheduled services.
• Provide exceptional customer service by demonstrating strong analytical and organizational skills, a thorough understanding of insurance guidelines and managed care requirements, and a commitment to patient care.
• Manage multiple priorities in a fast-paced healthcare environment while contributing to a positive patient experience.

Qualifications

• Sufficient experience to demonstrate ability to accept responsibility as a Hospital and Clinic prior authorization representative.
• Knowledge of anatomy and physiology, medical terminology and disease processes.
• Proficient keyboard skills and working knowledge of computer required.
• Good verbal and written communication skills.
• Cognitive, organizational and emotional abilities to deal effectively with multiple stressors, deadlines and customer needs.

Education

• A High school Diploma, HiSET or GED equivalent required.
• Completes Patient Financial Services I and training within first 5 months.