Prior Authorization Specialist
About this role
About the Role Under general direction, this position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications. It may include scheduling outpatient testing with other providers and coordinating patient appointments/orders. What You'll Do
- Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, Medicaid and Medicare Advantage plans, following the company's established policies and protocols.
- Select accurate and pertinent medical records from patients' charts from client's EMR.
- Obtaining demographic information and verifying insurance information.
- Provide all required clinical information to insurance companies necessary to facilitate the authorization process.
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