Prior Authorization Specialist - Medical
OVP Health Care
Wheelersburg, OH
- Full-Time
Job Description
Salary:
Primary Job Functions
- Responsible for reviewing, submitting, monitoring, and responding to issues regarding medication prior authorizations.
- Reviews patient medical history to identify supporting documentation in the patient chart relevant to the medication.
- Professionally communicates with prescribers, practice support staff, patients, and representatives of insurance companies; includes oral and written communication.
- Responsible for contacting insurance companies via appropriate method to obtain prior authorization.
- Updates information in the patient medical record with approval or declination information; follows up with ordering physician as to status of prior authorization.
- Efficiently tracks pending authorizations for multiple offices/prescribers.
- Creates a positive, professional, service-oriented work environment for staff, patients, and family members by supporting the mission and values of OGG.
Secondary Job Functions:
- Maintain confidentiality of patient and financial information by utilizing HIPPA guidelines and regulations.
- Responsible for reviewing, submitting, planning, and tracking of referrals made by clinic providers.
- Adheres to all Federal, State, and Local laws and regulations as well as policies.
Knowledge, Skills, and Abilities
- Knowledge of third-party payers and prior authorization requirements
- Understanding of basic medical terminology and medications
- Proficient use of office equipment, such as copier, fax machine, phones, etc.
- Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical record systems.
- Strong time management skills
- Ability to work independently with minimal supervision and to manage multiple priorities.
Credentials and Experience
- Must have a high school diploma or equivalent.
- One (1) year of experience and relevant knowledge of insurance eligibility or prior authorization in a healthcare setting preferred.
- Certified pharmacy technician, certified medical assistant, or licensed practical nurse preferred.
Address
OVP Health Care
Wheelersburg, OH
45694
USA
Industry
Education
Posted date
23 days ago
How can the hiring manager reach you?
You Already Have an Account
We're sending an email you can use to verify and access your account.
If you know your password, you can go to the sign in page.