Prior Authorization Representative

Abacus Serivice Corporation

Mason, OH

Expired: 12 days ago Applications are no longer accepted.

$21 Hourly
Vision , Medical , Dental , Paid Time Off , Life Insurance
Full-Time

Job Description

Key Responsibilities:

Prior Authorization Management: Review and evaluate medical service requests, including procedures, tests, and medications, to determine if prior authorization is required.
Gather all relevant medical documentation, such as medical records, test results, and clinical notes, to support the authorization request.
Insurance Verification: Verify patient insurance coverage, including benefits, eligibility, and limitations. Obtain and document necessary insurance information to ensure accurate billing and reimbursement.
Documentation and Communication: Prepare and submit prior authorization requests to insurance companies or third-party payers, adhering to their specific guidelines and requirements.
Maintain accurate and organized records of all authorization requests, follow-up activities, and outcomes.

Qualifications and Skills:

High school diploma or equivalent.
Prior experience in healthcare administration, medical billing, or insurance coordination is highly preferred.
Strong knowledge of medical terminology, CPT codes, ICD-10 codes, and insurance procedures.
Familiarity with insurance plans, prior authorization requirements, and reimbursement processes.

Company Description

Abacus Service Corporation is a nation-wide staffing firm based out of Farmington Hills, Michigan that services Fortune 500 companies in varying industries across the US. This is a full-time position offering excellent benefits such as medical, dental, vision, long and short term disability, life insurance, FSA and 401k options.