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Prior Authorization Specialist

Great Salt Plains Health Center, Inc. Oklahoma City, OK

  • Expired: over a month ago. Applications are no longer accepted.
Job Description
We are looking for Full-Time Prior Authorization Specialist to join our GSP Team!    We Offer: 
  • Health, Dental and Vision
  • Basic Life & LTD
  • Retirement Matching
  • Paid Time Off
The Prior Authorization Specialist is a member of the interdisciplinary health care team who is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all applicable payers.  
Qualifications: A.   High school diploma or GEDB.   Minimum of 2 years healthcare experience required, preferred direct experience with prior authorizations.C.   Knowledge of Medical Terminology preferred. D.   Self-directed and must make complex decisions. E.   Knowledge of procedure authorization and the direct impact on GSP Health’s revenue cycle.F.    Understanding of payer medical policy guidelinesG.   Basic Understanding of human anatomyH.   Proficient use of CPT and ICD-10 codesI.     Excellent computer skills including Excel, Word, and internet useJ.    Ability to plan and prioritize to meet deadlinesK.    Ability to communicate clearly and effectively with excellent customer service skillsL.    Ability to remain focused while managing a high-volume, time-sensitive workload
Specific Functions:A.    Accountable for planning, execution, appeals and efficient follow through on all aspects of the prior authorization process. B.     Provides multiple and complex details to insurance carriers by anticipating their questions when reviewing and retrieving relevant information from the electronic medical record. C.     Provides detailed and timely communication to both payers and clinical staff. D.    Responsible for documenting the appropriate information in the patient’s record. E.     Collaborates with providers regarding authorizations that may require escalation to peer-to-peer review. F.      Completes necessary authorization paperwork for approval of medications, DME and other assistance for GSPHC patients.G.    Completes notification to all insurance carriers via electronic/fax/telephone means within 24 business hours of service to ensure timely completion of prior authorizations. H.    Answers all provider, staff, and patient questions surrounding insurance authorization requirements.

Great Salt Plains Health Center, Inc.

Address

Oklahoma City, OK
USA

Industry

Education

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