[Hiring] Prior Authorizations Specialist @Infinx

Remote, USA Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Under general direction, this position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, and could include scheduling appointments for outpatient testing with other providers, coordinates patient appointments/orders. • Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, and Medicare Advantage plans, following the company's established policies and protocols. • Select accurate and pertinent medical records from patients' charts from client's EMR. • Obtain demographic information and verify insurance information. • Provide all required clinical information to insurance companies necessary to facilitate the authorization process. • Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner. • Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers. • Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements. Qualifications • High School Diploma or GED as a basic qualification • Proficiency in processing prior authorizations, with at least 5+ years of experience • Minimum of 2 years calling and communication with insurance companies via phone • Familiarity with medical terminology • Strong teamwork capabilities, self-motivation, and reliability • Basic computer literacy • Reliable, must have the ability to work well in a team setting, and be a self-starter Requirements • Experience processing PAs for acute hospital outpatient ancillary services • Experience training and working remotely Benefits • Access to a 401(k) Retirement Savings Plan. • Comprehensive Medical, Dental, and Vision Coverage. • Paid Time Off. • Paid Holidays. • Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services. Apply tot his job
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