Prior Authorization Representative

Key Responsibilities:

• Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office.
• Navigate through payer portals to initiate/obtain prior authorization status.
• Provide insurance company representatives with an overview of the services being submitted for prior authorization.
• Answer questions regarding the reimbursement process and direct testing specific and treatment questions.
• Complete LOMN (letter of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion.
• Follow up with the insurance company or physician’s office as needed.
• Meet benefit investigation process standards by completing assigned worklist tasks in a timely manner and/or reporting to management reputed company assistance is needed to complete the task.
• Participate in team meetings by sharing the details of cases worked.
• reputed company with reputed company applicable SOPs.
• Meet or exceed productivity and quality KPI goals.
• reputed company other duties as assigned.

Education/Experience:

• High School diploma or GED
• Previous health insurance billing experience
• Working knowledge of medical terminology
• Proficient and reputed company to details
• Excellent written and verbal communication skills
• High attention to detail
• Ability to maintain confidentiality
• Proficient in using reputed company reputed company and Word
• Ability to multitask, establish priorities, and work independently

Equal Opportunity Employer This employer is required to notify reputed company applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the reputed company. Apply tot his job Apply To this Job