Job Summary
We are seeking a proactive and detail-oriented Prior Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing the authorization process for medical services, i.e. prescriptions, specialty drugs, etc. Your expertise will help streamline workflows, reduce delays, and improve overall patient satisfaction. This position offers an exciting opportunity to work in a dynamic healthcare environment where your medical background will make a meaningful difference.
Duties
- Review patient records and medical documentation to determine eligibility for prior authorization requests
- Submit authorization requests accurately and efficiently using appropriate managed care protocols
- Follow up to track approval status and resolve any issues or denials promptly
- Maintain detailed records of all authorization activities, including approvals, denials, and appeals
- Collaborate with healthcare providers to gather necessary documentation and clarify authorization requirements
- Ensure compliance with HIPAA regulations by safeguarding patient information during all processes
Requirements
- Proven experience in medical office administration with a focus on prior authorizations
- Strong knowledge of medical terminology and medical records management
- Familiarity with prior authorizations a plus
- Experience working in a healthcare setting such as a medical office environment is highly desirable
- Excellent organizational skills with the ability to handle multiple cases simultaneously under tight deadlines
- Knowledge of HIPAA regulations to ensure patient confidentiality at all times
- Office experience with proficiency in electronic health records (EHR) systems and Microsoft Office applications
This is a very Part-Time position offering 10 to 16 hours per week.
Pay: $20.00 - $22.00 per hour
Benefits:
Ability to Commute:
- Lone Tree, CO 80124 (Preferred)
Work Location: In person
