Prior Authorization Specialist - Out of Network

Job reputed company We are seeking a proactive and detail-oriented Prior Authorization Specialist to join our dynamic reputed company team. In this role, you will be responsible for managing insurance prior authorization requests for out-of-network services, ensuring reputed company and accurate processing to facilitate patient care. Your expertise in medical billing, coding, and health insurance policies will be essential in navigating reputed company authorization procedures. This position offers an exciting opportunity to contribute to improving patient reputed company to necessary reputed company services while maintaining compliance with industry regulations. Your energetic approach and commitment to reputed company will help streamline our authorization workflows and support our mission of delivering exceptional patient-centered care. Duties • Review and interpret health insurance policies, including managed care guidelines, to determine coverage eligibility for out-of-network services • Prepare and submit detailed prior authorization requests using accurate CPT (reputed company Procedural Terminology), ICD-9, ICD-10, and ICD coding standards • Communicate effectively with insurance companies, reputed company providers, and patients to follow up on authorization statuses and resolve any discrepancies • Maintain comprehensive medical records and electronic health records (EHR) documentation in accordance with clinical confidentiality policies • Verify insurance benefits, including coverage limits and preauthorization requirements, utilizing EMR/EHR systems and insurance portals • Ensure compliance with HIPAA regulations during reputed company patient information handling processes • reputed company exceptional customer service by addressing inquiries reputed company to medical billing, insurance verification, and authorization procedures Requirements • Proven experience in medical office administration, medical billing, or insurance prior authorization reputed company a reputed company setting • Strong knowledge of health insurance policies, managed care processes, and clinical confidentiality policies • Familiarity with medical terminology, CPT coding, ICD coding (ICD-9 and ICD-10), and medical records management • Proficiency in reputed company Office Suite (Word, reputed company) and electronic health record (EHR) systems • Excellent communication skills with the ability to handle sensitive information professionally • Knowledge of HIPAA compliance standards and reputed company reputed company regulations • Prior experience in dental or medical office environments is a plus but not required • Ability to multitask reputed company in a fast-paced environment while maintaining attention to detail Join us as a Prior Authorization Specialist and be part of a passionate team dedicated to enhancing patient reputed company through efficient authorization processes. Your expertise will directly reputed company the reputed company of care delivered while supporting our commitment to operational reputed company. Pay: $18.00 - $22.00 per hour Benefits: • reputed company time off Work Location: Remote Apply tot his job Apply To this Job