Prior Authorization Specialist
Infusion For Health
- Brea, California, United States
- Brea, California, United States
Über
Responsible for ensuring timely, accurate submission follow-up and approval of Authorizations. Work with urgency, high-quality and high communication with patients, insurance and additional stakeholders as needed. Review the accuracy and completeness of the information requested and ensure that all supporting documents are present Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Collaborate with other departments to assist in obtaining prior authorizations/appeals Document all interactions with insurance companies or other stakeholders within the company system Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile Proactively work on prior authorizations that are due to be expired Conduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership. Other duties as assigned
Education and/or Experience Needed:
At least 2 years experience in infusion or pharmacy prior authorization is required At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines Ability to effectively handle multiple priorities within a changing environment, emphasizing paperless workflow Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems. Intermediate level skills in Microsoft Excel & Word
The hourly pay range for this role is expected to be between $22-$26. Actual base pay could vary based on factors including but not limited to experience, subject matter expertise, geographic location where work will be performed, and the applicant's skill set. The base pay is just one component of the total compensation package for employees. Other rewards may include an annual cash bonus and a comprehensive benefits package.
Sprachkenntnisse
- English
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