Prior Authorization and Scheduling Representative

Prior Authorization and Scheduling Representative (onsite position, not remote)
Location: Tulsa, OK
Schedule: Monday - Friday, 8:00 AM - 5:00 PM
Compensation: Based on Experience ($17.00 - $19 per hour)

Prior Authorization and Scheduling Representative Position Overview:

We are seeking a detail-oriented and motivated Prior Authorization and Scheduling Representative to join our team in Tulsa, OK. This role is essential in coordinating patient services by managing prior authorizations and scheduling specialized studies. The ideal candidate will have strong analytical skills, attention to detail, and a solid understanding of healthcare authorizations, pre-certification, and scheduling processes.

Prior Authorization and Scheduling Representative Key Responsibilities:

• Obtain Prior Authorizations: Secure necessary authorizations for special studies from various insurance carriers using carrier-specific tools and systems.
• Maintain Pre-Certification Knowledge: Keep current with each payer's pre-certification requirements, leveraging payer-specific websites and resources.
• Clinical Data Analysis: Evaluate and interpret clinical data in relation to authorization requests, cross-referencing medical terms, diagnoses, and CPT codes to ensure compliance with insurance requirements.
• Eligibility & Benefits Verification: Confirm eligibility and benefits for each special study request, ensuring accurate and compliant processing.
• Scheduling Coordination: Arrange appointments for authorized special studies, coordinating with patients and clinical teams to ensure optimal scheduling and resource utilization.
• Documentation: Accurately enter and maintain detailed notes in the practice management system regarding referrals, authorizations, special studies, and scheduling.

Prior Authorization and Scheduling Representative Qualifications:

• Familiarity with medical terminology, CPT codes, healthcare authorization, and scheduling processes
• Strong analytical, organizational, and data management skills
• Proficiency in using payer-specific websites, tools, and scheduling software

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