Prior Authorization Representative

DaMar Staffing Solutions

  • Indianapolis, Indiana
  • 30+ days ago

    Highlights

    Job Summary-Prior Authorization Representative is responsible for securing inpatient/outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorizations before service are rendered. High School Diploma, 3+years of experience in a health care financial setting or medical office setting.

    Numbers & Facts

    LocationIndianapolis, Indiana

    Description

    Prior Authorization Representative Job Description 

     

    Client Profile- An Indiana based Independent Physician-Owned radiology practices founded in 1967.   

     

    Job Summary-Prior Authorization Representative is responsible for securing inpatient/outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorizations before service are rendered.  Must be comfortable working with clinical professionals. 

     

    Job Duties 

    • Verify insurance eligibility, benefits, network status and create pre-service liability estimate. 

    • Ensure accurate ICD, CPT codes and related medical records are submitted in the authorization request. 

    • Secure prior authorizations of inpatient and outpatient imaging. 

    • Acts as a liaison between the payer and clinic schedulers/medical support. 

    • Follows up on delayed or denied authorizations requests and escalates for resolution. 

    • Create detail documentation and maintain/stores the authorization paper trail. 

     



    Requirements

    Qualifications 

    • High School Diploma, 3+years of experience in a health care financial setting or medical office setting. Must have previous prior authorization experience. 

    • Excellent customer service skills, strong attention to details, multi-task as needed. 

    • Must be familiar with an EMR or HER; Microsoft Office 365 

    • Must be able to take responsibility and work under pressure.  Work efficiently in a busy medical office. 

    • Must be a positive team player. 

    • Knowledge of ICD-10, CPT, and HCPCS codes specific to radiology is a plus. 

    • Proficient in medical terminology, especially radiological terms and procedures. 

    • Days/Hours: M/F 8a to 5pm (Availability to start as early as 7a and work as last as 6:00pm is a plus) 

    • Starting pay $20.00 to $21.00 hourly (Based on experience) 

     



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