Prior Authorization Coordinator Jobs

Why You'll Love this Job

Retina Associates of Utah (RAU) is seeking an individual who will be responsible for performing an extensive number of prior authorization and insurance verification functions, as delegated by the physician to allow for proper professional treatment of patients’ conditions. This candidate will support the billing authorization needs for our practice.

Retina Associates of Utah (RAU) is one of the largest and most respected retina-only ophthalmology practices in Utah, committed to Preserving the Patient's Vision. All Retina Associates of Utah physicians are board certified by the American Board of Ophthalmology and specialize exclusively in diseases and surgery of the retina, vitreous, and macula. Our surgeons have studied at some of the most renowned institutions in the nation and all have graduated at the very top of their classes.

Retina Associates of Utah follows all CDC and local authority protocols to ensure the safety and well-being of the patients, providers, employees and communities.

Retina Associates of Utah is proud to be an Equal Employment Opportunity and an Affirmative Action Employer. We are committed to creating an inclusive work environment that celebrates diversity.

Responsibilities

Prior Authorization Specialist Responsibilities:?

• Maintains and adheres to the company’s OSHA, HIPAA, and Compliance regulations.
• Provides a completed patient verification and authorization record in a timely manner.
• Utilizes problem-solving skills in verifying inaccurate information recorded in the clinic financial system. Knows when it is appropriate to use Availity, the insurance portal, or call the patient.
• Consistently forwards patients who have outstanding balances to a Patient Accounts Specialist.
• Provides immediate verification of benefits as needed for same or next day added-on patient appointments.
• Utilizes patient charts on an as needed basis, accessing only information related to treatment, payment, and health operations.
• Obtains authorizations from insurance companies and records notes accurately in the practice management system in a fast and efficient manner.
• Uses good judgment in contacting the patient for discovered unforeseen issues (i.e. anticipated procedure not covered, large copay or coinsurance, patient’s insurance premium was not paid).
• Other duties as assigned.
• Uses judgment in forwarding patients to a Patient Accounts Specialist for arrangements payment plans for services that are not covered by insurance and there is a need to discuss different financing options to fit their budgets.

Qualifications

Billing and Collections Qualifications:

• Excellent communication skills
• Ability to prioritize tasks properly
• Must have knowledge of current insurance companies and electronic portals

• Ability to work in a fast pace environment
• Knowledge of billing procedures and collection techniques
• Ability to work in multiple software programs/applications
• Answer multi-line telephones
• Exhibit patience and compassion

• Ability to read and understand EOBs
• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)
• Excellent verbal and written communication skills
• Experience using medical billing software
• Excellent understanding of AR processes, third party payer and CMS regulations

• Dependable and consistently completes work tasks
• Self- directed with ability to work with minimal supervision