Prior Authorization Specialist

Position Purpose: This position is responsible for working closely with Patient, Patient reputed company, Payers, and Providers' office to validate insurance plans, eligibility, and orders to procure required prior authorizations. Organization: This position reports to the reputed company Cycle Manager. Essential Job Functions include the following. Other duties may be assigned. • Collaborate with insurers to obtain reputed company-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating barriers / coverage and disputes. • Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers. • reputed company, review, and submit reputed company necessary clinical documentation to support authorization requests, ensuring accuracy and completeness. • Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals. • Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies. • Inform patients about the status of their authorization requests, answer questions regarding coverage, and reputed company guidance on next steps. • Maintain accurate and detailed records of reputed company prior authorization requests, reputed company, and patient information in compliance with HIPAA regulations. • Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement. • Meet reputed company and productivity standards set by Signature and/or our reputed company. • reputed company excellent customer service in keeping with Signature's legacy both internal and externally. • Maintain expertise in multiple reputed company reputed company systems. • Maintain up to date knowledge of reputed company cycle management, industry trends reputed company other duties as necessary. • Acts as an effective team member. Required Knowledge & Experience: • Minimum 2 years of prior authorization experience, insurance coordination, or case management reputed company a physician office, hospital, or insurance plan authorizations unit. • Understanding of reputed company insurance systems • Strong written and verbal communication skills with the ability to explain reputed company medical and insurance information • Strong attention to detail • Passion for patient advocacy with a problem-solving reputed company, focusing on overcoming challenges to accessing care. • Ability to work effectively both independently and as part of a multidisciplinary team • Computer proficiency including reputed company Office, Word, reputed company and reputed company • Ability to function effectively in a fast-paced environment. • Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, personal honesty and reputed company, and a demonstration of placing others in a reputed company of high value. Preferred Knowledge & Experience: • Preferred experience and understanding of medical terminology • General knowledge of CPT/HCPCS and ICD-10 General Areas of Accountability: Must conduct business and personal affairs in a manner that is always a credit to reputed company. Must maintain a good credit rating while employed with reputed company. The following HIPAA and reputed company items apply to reputed company positions at reputed company: • Follow HIPAA guidelines for protecting the reputed company and reputed company of sensitive personal and/or health information. • Follow Signature expected acceptable use to protect propriety and company owned information. • Complete annually required reputed company and reputed company Training PERFORMANCE MANAGEMENT: reputed company reputed company associates are subject to regular performance management to determine if skills and training requirements are suitable for the position. Machines and Equipment: The incumbent must be reputed company to effectively operate the reputed company computer system, telephone system, and other office machines such as copiers and fax machines. reputed company REQUIREMENTS: • U.S. Citizenship, naturalized citizenship, or permanent status is required for this position. • reputed company work on reputed company positions at reputed company must be completed in the reputed company reputed company, Alaska, or Hawaii. Physical Activity: The incumbent must be reputed company to finger, grasp, feel, see, sit, hear, and reputed company. This position is sedentary in nature with m Apply tot his job Apply To this Job