Insurance Prior Auth Specialist

Job Description

Job Description

Job description:

About us

Manhattan Medical Group's is currently looking for a Prior Authorization Specialist.

The Prior Authorization Specialist performs the duties of working with the Insurance companies for the purpose of getting testing and procedures approved for the patient before it can be scheduled. They are responsible for communicating with Providers and clinical staff on getting approved or what is needed if the request is denied.

The Prior Authorization Specialist is responsible for:

• Authorizations department for Manhattan Medical Group.

• Review providers schedule to make sure all Doctor's order are input into our EMR.

• Confirm the patients insurance, if applicable, the requested test and or procedures, are authorized.

• Communicates with the patient's healthcare team and insurance for approvals.

• Process retroactive through Insurances, as needed.

• If treatment is denied, make initial call to the patient explaining the denial and start the appeal process.

We are looking for the following skills and experience:

• A service oriented teamwork mindset

• Written and verbal communication skills with personal, patients and patient contacts.

• Exceptional time management skills, multi-tasking and prioritize tasks

• Knowledge of medical terminology required.

• Knowledge of Insurance plans preferred.

• Able to evaluate situations in an objective, consistent and fair manner.

• Able to utilize effective problem-solving methods with dealing with staff, healthcare professionals, patients and insurance companies.

Job Type: Full-time

Benefits:

Experience:

• EMR systems: 2 years (Preferred)

• Prior Authorization Specialist: 2 years (Preferred)