Prior Authorization Specialist

our privacy is important to us. All applications are strictly confidential.Refuah Health is a federally qualified health center offering comprehensive care in Rockland and Sullivan Counties. We are over one hundred healthcare professionals strong with three decades’ experience providing unparalleled patient care. As an FQHC, we specialize in accessible and affordable care for low income and high-risk residents. We believe in the power of people to create great care and we are inviting the best to build their career with us!Why Refuah?Join a collegial team of coworkers.Five modern state of the art facilities.Flexible schedules for maximum work-life balance.No experience required. Full training provided.The Prior Authorization Specialist is responsible for obtaining pre-certifications and authorizations for Refuah patients. They take ownership and serve as the last line of defense against errors.Duties and responsibilities:Contact insurance companies to verify benefits eligibilityCollaborate with Refuah providers to resolve and appeal denied authorizationsEnsure all services have prior authorizations. Utilize EMR system checking encounters when necessary and assign to the appropriate provider.Maintain knowledge of Medicaid and third party insurance requirementsVerify insurance for in-network or out-of-network benefitsPre-certify services including surgery, office visits, diagnostic testing or any procedure that requires pre-certificationReview Pediatric referrals from previous day and help schedule appointmentsMaintain strict patient confidentialityMaintain authorization records documentationComplies with applicable policies and procedures and supports the Compliance ProgramContributes to organizational operations by performing other duties as may be requiredHigh School DiplomaKnowledge of the health care field with regards to insurance carrier regulationsPrior experience as a Medical AssistantWillingness and ability to quickly learn new software systems and workflowsComfort with, and reliability in, performing repetitive or detail‑oriented (tedious) tasks accurately and efficiently.Good interpersonal and communication skillsAbility to project a pleasant and professional imageAbility to effectively manage conflicts and resolve problemsApply Today:If you are looking to make a positive impact, we invite you to apply. Join Refuah in transforming the healthcare experience. Apply now to be a part of our dynamic team.Principals only. Recruiters, please do not contact us regarding this job. #J-18808-Ljbffr