1

Prior Authorization Associate Jobs in Missouri (NOW HIRING)

$23.63 - $35.49/hr

Initiates and facilitates prior authorization process. * Contacts appropriate insurance companies ... Associate degree Certifications /Professional Licenses : Certified Professional Coder (CPC ...

$53K - $71K/yr

Completion of required academic credits (150 credit hours) must be met prior to the start date ... Mazars must be legally authorized to work in the United States. Verification of employment ...

Completion of required academic credits (150 credit hours) must be met prior to the start date ... Mazars must be legally authorized to work in the United States. Verification of employment ...

Completion of required academic credits (150 credit hours) must be met prior to the start date ... Mazars must be legally authorized to work in the United States. Verification of employment ...

Front Office Associate

Saint Louis, MO · On-site

$15.50 - $18.75/hr

Front Office Associate RAYUS Radiology is looking for a Front Office Associate to join our team. We ... obtain pre-authorization, if needed, prior to patient appointments * Facilitate Release of ...

Front Office Associate

Creve Coeur, MO · On-site

$15.50 - $18.75/hr

As a Front Office Associate, you will be responsible for providing services to patients and ... obtain pre-authorization, if needed, prior to patient appointments * Facilitate Release of ...

Showing results 21-40

Prior Authorization Associate information

What is a prior authorization associate?

Prior Authorization Associates are professionals who handle the process of obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. They review clinical documentation, communicate with healthcare providers and insurers, and ensure all necessary information is submitted for timely authorization. Their work helps reduce claim denials and ensures patients receive the care they need while adhering to insurance requirements.

What are the key skills and qualifications needed to thrive as a prior authorization associate?

To thrive as a Prior Authorization Associate, you need a strong understanding of medical terminology, insurance processes, and prior authorization requirements, often backed by a high school diploma or associate degree. Familiarity with healthcare management software, electronic health record (EHR) systems, and payer portals is typically required. Excellent attention to detail, organizational skills, and effective communication are essential soft skills for this role. These skills ensure timely and accurate processing of prior authorizations, minimizing delays in patient care and supporting efficient healthcare operations.

What are some common challenges faced by a prior authorization associate, and how can they be effectively managed?

Prior Authorization Associates often encounter challenges such as navigating complex insurance requirements, handling high volumes of authorization requests, and managing tight turnaround times. Staying organized, keeping up-to-date with payer policies, and using robust tracking systems can help manage these difficulties. Collaborating closely with clinical staff and insurance representatives is also essential for resolving issues quickly and ensuring approvals are processed efficiently. Developing strong communication and problem-solving skills is key to success in this role.

What is the difference between Prior Authorization Associate vs Medical Billing Specialist?

AspectPrior Authorization AssociateMedical Billing Specialist
CredentialsHigh school diploma or equivalent; certification in medical billing or coding often preferredHigh school diploma or equivalent; certification in medical billing or coding often preferred
Work EnvironmentHealthcare offices, insurance companies, hospitalsHealthcare offices, billing companies, hospitals
Primary ResponsibilitiesObtain prior authorizations from insurance for procedures and treatmentsProcess and submit medical claims, handle billing and payments

The main difference is that a Prior Authorization Associate focuses on securing insurance approvals before procedures, while a Medical Billing Specialist manages the billing process after services are rendered. Both roles require similar credentials and often work in healthcare settings, but their core functions differ in the patient care and revenue cycle process.

Is a prior authorization associate a stressful job?

A prior authorization associate's job can be stressful due to the need for accuracy, meeting deadlines, and managing complex insurance requirements. The role often involves handling high volumes of requests and communicating with healthcare providers and insurers, which can contribute to workplace pressure.

What are the most commonly searched types of Prior Authorization jobs in Missouri?

The most popular types of Prior Authorization jobs in Missouri are:

What are popular job titles related to Prior Authorization Associate jobs in Missouri?

For Prior Authorization Associate jobs in Missouri, the most frequently searched job titles are:

What cities in Missouri are hiring for Prior Authorization Associate jobs?

Cities in Missouri with the most Prior Authorization Associate job openings:

Regulatory & Quality Assurance Pharm Tech (EPIC Experience Highly Preferred)

Children's Mercy KC

Kansas City, MO

$24.18/hr

Full-time

Posted 4 days ago


Children's Mercy Kansas City rating

8.3

Company rating: 8.3 out of 10

Based on 57 frontline employees who took The Breakroom Quiz

85th of 1,060 rated hospitals


Job description

Thanks for your interest in Children's Mercy!

Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years.

Children's Mercy is in the heart of Kansas City - a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children's health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital.

Overview

The Prior Authorization Pharmacy Technician is part of the team that helps to ensure timely and accurate access to prescription medications for Children's Mercy patients.  This includes securing authorization for the medication through the patient's prescription insurance, seeking copay assistance options for the patient, and seeking free drug from manufacturer programs for uninsured and underinsured patients. The technician will provide excellent customer service to communicate prescription costs and insurance requirements with patients and caregivers.

Candidates for this position should be familiar with the prior authorization process and be able to navigate Epic.

At Children's Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity.

Additionally, it's important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children's Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005. If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources.

Responsibilities
  • Procures and distributes medication orders per physician request, or prearranged work assignment according to established policies, procedures, and protocols.
  • Provides education to staff related to medication preparation, controlled substances, 340b program and VFC program
  • Maintains quality assurance and regulatory compliance for medication preparation areas.
  • Responsible for overseeing assigned procedures involving technician staff
  • Conducts internal pharmacy audits of controlled substance transactions and 340b purchased drug dispenses
Qualifications
  • HS diploma or equivalent and 3-5 years experience Experience in a pharmacy setting as a pharmacy technician. or
  • Associate's Degree and 1-2 years experience Experience in a pharmacy setting as a pharmacy technician.
  • One of the following: Certified Pharmacy Technician - National, ExCPT Pharmacy Technician required upon hire
  • Registered Pharmacy Technician - MO
  • Registered Pharmacy Technician - KS
  • Employees must obtain Registered Pharmacy Technician - MO or equivalent within 90 days
  • PHARM TECH REG MO Registered Pharmacy Technician - MO or proof of application submitted to board of pharmacy prior to hire with license obtained within 90 days of hire. Only if primary work location is in Missouri. Required 90 Days
  • PHARM TECH REG KS Registered Pharmacy Technician - KS or proof of application submitted to board of pharmacy prior to hire with license obtained within 90 days of hire. Only if primary work location is in Kansas. Required 90 Days
Benefits at Children's Mercy

The benefits plans at Children's Mercy are one of many reasons we are recognized as one of the best places to work in Kansas City. Our plans are designed to meet the changing needs of our employees and their families.

Learn more about Children's Mercy benefits. Starting Pay

Our pay ranges are market competitive. The pay range for this job begins at $24.18/hr, but your offer will be determined based on your education and experience.

Remote Work/Work from Home

This position is not eligible to work remotely, which means that the person hired will be required to work onsite at one of our Children's Mercy locations and may not work from home.

EEO Employer/Disabled/Vet

Children's Mercy hires individuals based on their job skills, expertise and ability to maintain professional relationships with fellow employees, patients, parents and visitors. A personal interview, formal education and training, previous work experience, references and a criminal background investigation are all factors used to select the best candidates. The hospital does not discriminate against prospective or current employees based on the race, color, religion, sex, national origin, age, disability, creed, genetic information, sexual orientation, gender identity or expression, ancestry or veteran status. A drug screen will be performed upon hire. Children's Mercy is smoke and tobacco free.

CM is committed to creating a workforce that supports the diverse backgrounds of our patients and families. We know that our greatest strengths come from the people who make up our team, so we hire great people from a wide variety of backgrounds, not just because it's the right thing to do, but because it makes our hospital stronger and our patient care more compassionate.

If you share our values and our enthusiasm for service, you will find a home at CM. In recruiting for our team, we welcome the unique contributions that you can bring, including education, ideas, culture, and beliefs.

Employment Type: OTHER

What Children's Mercy Kansas City employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Children's Mercy KC logo

About Children's Mercy KC

Sourced by ZipRecruiter

Children’s Mercy KC is a revered health care institution based in Kansas City, MO, US. Known to be one of the top pediatric medical centers in the United States, the establishment is dedicated to offering holistic medical care, pioneering research, and comprehensive education to enhance the well-being of children. Originally founded in 1897 by Alice Berry Graham and her sister, Katharine Berry Richardson, Children's Mercy has since then grown into a multifaceted institution providing world-class pediatric health services.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Kansas City, MO, US

Year founded

1897