We are seeking a Pre-Authorization Specialist to become an integral part of our team!
The Pre-Authorization Specialist core duties consist of contacting insurance companies and other third-party administrators to determine pre-authorization and/or medical necessity requirements for basic and high-tech outpatient radiology exams and procedures. Obtaining the pre-authorization prior to the scheduled service being performed. Liaisons with clients, physicians and physician office staff when needed to obtain additional clinical documentation.
The ideal candidate will have direct experience with radiology and/or the pre-authorization process with insurance companies and third-party administrators. The ability to communicate clearly and professionally with payers and customers is a must as we feel that direct communication with the client provides a competitive advantage.
- Confirm all necessary documents required for accurate submission of the pre-authorization request are available and communicate with clients when additional documentation is required
- Responsible for verifying eligibility and obtaining pre-authorizations as needed per insurance company requirements
- Contact insurance companies and third-party administrators to ensure prior approval requirements are met, present necessary medical information such as history and diagnosis.
- Responsible for tracking, following up on, and extending authorizations from insurance companies and third-party administrators in a timely manner
- Perform other job-related duties as assigned
- Experience in customer service
- Radiology experience a plus
- Knowledge of medical terminology
- Knowledge of insurance benefits
- Experience with authorizations
- Good written and verbal communication skills
- Organization and multi-tasking skills