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Preauthorization Specialist Jobs

Preauthorization Intake Jobs
By Injury Management Organization, Inc. At Plano, TX, United States

Once the training is completed, after the first 60 days, this position is a hybrid role with 3 days remote and 2 days in office. The successful candidate will have a solid medical background/medical ...

Clinical Team Lead/Lpn - Preauthorization
By Capital Blue Cross At , Harrisburg, 17177
Experience in researching evidence-based and industry standards and requirements relevant to medical management programs.
Knowledge of regulatory requirements for Utilization Management including URAC, NCQA, Act 68, ERISA, DOH, HIPAA and CMS.
Minimum of two (2) to three (3) years of managed care experience, specifically in utilization management and/or case management.
Strong team skills with the ability to work and interact with management level staff both within and outside of Clinical Management.
Knowledge of current and emerging medical treatment modalities with the ability to analyze and interpret medical and benefit coverage interrelationships.
Knowledge of managed care principles and emerging health treatment modalities.
Scheduling & Preauthorization Coordinator Ii
By University of Maryland Medical System At Baltimore, MD, United States
Reports adverse events and near misses to appropriate management authority.
Complies with IDX scheduling standards. Monitors overbooking and/or conflicting scheduling situations and informs the clinic manager..
Proficient in PC applications and accurate data entry. Use of other medical registration system and/or STAR/IDX preferred..
Successful completion of the UMMS computer systems certification test within one attempt and maintain a minimum of 90% accuracy.
Knowledge of medical terminology in order to understand diagnoses to schedule appointments.
Ability to prioritize and manage numerous tasks in different stages of completion.
Scheduling & Preauthorization Coordinator Jobs
By University of Maryland Medical System At Baltimore, MD, United States
Reports adverse events and near misses to appropriate management authority.
Demonstrated knowledge of various insurance coverage (i.e. Medicaid, HMOs).
Effective listening skills with the ability to listen and understand patient information and translate it to written documentation.
Ability to use resourcefulness and problem-solving skills when handling telephone and in-person inquiries or when required to resolve patient scheduling issues.
Ability to prioritize and manage numerous tasks in different stages of completion.
Reminds patients of upcoming appointments, changes to schedules, co-payments required, and pertinent insurance information.

Are you looking for a challenging and rewarding career in healthcare? We are looking for a Preauthorization Specialist to join our team! As a Preauthorization Specialist, you will be responsible for verifying insurance coverage, obtaining preauthorization for services, and ensuring that all services are properly authorized. You will also be responsible for providing excellent customer service to our patients and their families. If you are looking for an opportunity to make a difference in the lives of others, this is the job for you!

Overview A Preauthorization Specialist is responsible for obtaining preauthorization from insurance companies for medical services and procedures. They review patient records and insurance information to determine if the requested services are covered by the patient’s insurance and if preauthorization is required. Detailed Job Description A Preauthorization Specialist is responsible for obtaining preauthorization from insurance companies for medical services and procedures. They review patient records and insurance information to determine if the requested services are covered by the patient’s insurance and if preauthorization is required. They must contact insurance companies to obtain preauthorization and to verify coverage. They must also review and interpret insurance policies and regulations to ensure compliance with insurance requirements. They must also maintain accurate records of all preauthorization requests and follow up with insurance companies to ensure that preauthorization is granted. Job Skills Required
• Knowledge of medical terminology and coding
• Knowledge of insurance policies and regulations
• Excellent communication and customer service skills
• Ability to work independently and as part of a team
• Ability to multitask and prioritize tasks
• Excellent organizational and time management skills
• Proficiency in computer applications
Job Qualifications
• High school diploma or equivalent
• Previous experience in a medical office setting
• Certification in medical coding and billing
• Knowledge of insurance policies and regulations
Job Knowledge
• Knowledge of medical terminology and coding
• Knowledge of insurance policies and regulations
• Knowledge of medical office procedures
• Knowledge of HIPAA regulations
Job Experience
• Previous experience in a medical office setting
• Previous experience in a customer service role
• Previous experience in a billing or coding role
Job Responsibilities
• Obtain preauthorization from insurance companies for medical services and procedures
• Review patient records and insurance information to determine if preauthorization is required
• Contact insurance companies to obtain preauthorization and to verify coverage
• Review and interpret insurance policies and regulations to ensure compliance with insurance requirements
• Maintain accurate records of all preauthorization requests
• Follow up with insurance companies to ensure that preauthorization is granted