Prior Authorization/Referral SpecialistA Pre-Authorization/Referral Specialist is responsible for determining insurance eligibility/benefits and ensuring pre-certification (authorization/referral) requirements are met for both the facility and professional services. The Pre-Authorization/Referral Specialist provides detailed documentation and communication with both payors and clinicians to obtain prior-authorizations. Obtains clinical information to support medical necessity.
Knowledge, Skills & Abilities required:
Experience in pre-authorization/referrals, patient registration, insurance verification and health insurance plans
Knowledge of online insurance pre-authorization process and working with various payors
Excellent computer and customer service skills
Familiarity with Medical Terminology
Demonstrated ability to efficiently organize work, while maintaining a high level of accuracy and productivity
Knowledge of ICD-10, CPT and HCPC codes and use
Familiarity with internet, email and Microsoft Office
Effective written and verbal communication skills required
Compensation details: 17-25.25 Hourly Wage
PIfa2623a80d9c-37437-41383401
