Job Overview
We are seeking a proactive and detail-oriented LPN to join our healthcare team as our Prior Authorization Specialist. In this vital role, you will be responsible for managing the authorization process for medical services, ensuring timely approval from insurance providers to facilitate seamless patient care. Your expertise in managed care, medical terminology, and insurance verification will drive efficiency and accuracy in processing prior authorizations. This position offers an exciting opportunity to use your skills make a meaningful difference in patient outcomes.
Responsibilities
- Review and analyze patient documentation, including medical records and clinical notes, to prepare accurate prior authorization requests
- Communicate effectively with insurance companies to obtain necessary approvals
- Accurate verification of insurance coverage, benefits, and eligibility using managed care systems, insurance portals and communication with insurance
- Maintain comprehensive records of authorization requests, approvals, denials, and related correspondence in accordance with HIPAA regulations
- Collaborate with medical office staff, providers, and patients to gather required information and clarify authorization requirements
- Follow up regularly on pending authorizations to prevent delays in patient care delivery
- Complete all recertification of insurance during the patients stay
- Works with Case Manager to facilitate completion of admission and discharge paperwork
Requirements
- Proven experience in managed care or medical office settings with a strong understanding of insurance verification processes
- Familiarity with HIPAA compliance standards to safeguard patient privacy and confidentiality
- Prior experience working in a medical environment preferred
- Excellent organizational skills with the ability to handle multiple requests efficiently
Join us as a Prior Authorization Specialist and become an essential part of a dedicated healthcare team committed to delivering exceptional patient service. Your expertise will help streamline processes, reduce delays, and support our mission of providing high-quality care through effective managed care coordination.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k) matching
- Health insurance
- Paid time off
Work Location: In person
