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Prior Authorization Specialist Jobs in New Providence, Hardin, Iowa

Specialist - Authorization Jobs
By CharterCARE Health Partners At , North Providence, 02904

Location: CharterCARE Health Partners · 7639-Radiology Administration Schedule: Per Diem (0 hrs), 4 (Per Diem), 7a-330p

Prior Authorization Specialist - Remote
By Orsini Pharmaceutical Services At , Elk Grove
Experience with Major Medical Insurance.
Knowledge of HCPC Codes (J-Codes).
Knowledge of ICD-10 Codes (Diagnoses Codes).
Ability to convert a prescription into an authorization request based on payer requirements.
Respond to urgent emails submitted by the PCC Team or Program Manager in a timely manner.
Familiar with medical documentation such as H&P’s, Genetic testing, etc.
Prior Authorization Specialist - Remote
By Orsini Specialty Pharmacy At , Elk Grove, 60007
Experience with Major Medical Insurance.
Knowledge of HCPC Codes (J-Codes).
Knowledge of ICD-10 Codes (Diagnoses Codes).
Ability to convert a prescription into an authorization request based on payer requirements.
Respond to urgent emails submitted by the PCC Team or Program Manager in a timely manner.
Familiar with medical documentation such as H&P’s, Genetic testing, etc.
Prior Authorization Operations Supervisor
By Cochlear Ltd At , Lone Tree, 80124
Evaluate and adjust team member work and region assignments based on team member's knowledge, skill set and business need
Hybrid work environment with a combination of in-office and work from home
Bachelor's Degree or Equivalent Work Experience
1‐2+ years of leadership and/or coaching experience
Extensive knowledge of government insurance and commercial insurance
Lead and develop a team of 10+ reimbursement specialists
Or Scheduler/Prior Authorization Specialist - Surgery
By University of Iowa At Iowa, United States
A Bachelor's degree or an equivalent combination of education and experience.
Work with other OR schedulers and staff and communicate patient needs and responsibilities necessary prior to surgical procedures.
Fill OR time that is allocated to Departments and offer consultation on alternative dates or times to accommodate patients and staff.
Provide education and guidance to incoming providers and staff to onboard and understand the OR scheduling process.
Excellent written and verbal communication skills.
Demonstrates knowledge of effective strategies for working with diverse faculty, staff, and students.
Medical Authorization Specialist Jobs
By LifeNet Health At , Remote
Works with the Order Management team to secure any additional information and medical documentation from the patient and/or prescribing HCP.
Medical terminology and ICD-10 coding: Knowledge of and interpretation skills
One (1) year previous experience of insurance verification or medical authorization experience involving medical record review.
Personal career, skill, and leadership development opportunities
Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.
Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company’s products.
Billing Specialist Prior Authorization
By Planned Parenthood of the Rocky Mountains, Inc. At , Albuquerque, Nm $20.19 - $22.15 an hour
Scrubbing and auditing charts for correction and completeness
Billing research for new items and services
Key Approaches to the Work:
A predictable schedule and dedicated individualized paid training
(We contribute to your 401K after an allotted period of time)
Medical/Vision/Dental, with extended mental health coverage
Prior Authorization Specialist Jobs
By Great River Health At , West Burlington, 52655, Ia $16.50 an hour
We are excited to offer an aggressive compensation and benefits package for qualifying positions, which includes:
Medical front office or clinical experience required
High school diploma or equivalent
Matching 401(k) and 403(b) retirement programs, with on-site personal investment counseling
Health, Dental and Vision plans
Health Savings and Flexible Spending Accounts
Prior Authorization Specialist - Remote*
By Logan Health At , Remote
Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
Possess a working knowledge and understanding of ICD-10 and CPT codes required.
Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
Maintains the Logan Health intranet related to payer requirements needed to successfully obtain a prior authorization.
Notice of Pre-Employment Screening Requirements
Possess insight and understanding into reimbursement and claims procedures and its direct impact on the revenue cycle required.
Prior Authorization Specialist - Remote
By Orsini Specialty Pharmacy At , Elk Grove, 60007, Il
Experience with Major Medical Insurance.
Knowledge of HCPC Codes (J-Codes).
Knowledge of ICD-10 Codes (Diagnoses Codes).
Ability to convert a prescription into an authorization request based on payer requirements.
Respond to urgent emails submitted by the PCC Team or Program Manager in a timely manner.
Familiar with medical documentation such as H&P’s, Genetic testing, etc.
Authorization Specialist Jobs
By Lehigh Valley Health Network At , Allentown, 18103, Pa
Knowledge, Skills, and Abilities - Required:
Proficient in utilization management processes, standards, and managed care.
Knowledge of patient rights and laws relative to those rights, such as HIPAA.
Proficient in standard medical practices and insurance benefit structures.
Remote position with training on-site
High School Diploma/GED with specialized training in insurance, coding, billing, or similar healthcare certificate programs.
Authorization Specialist Jobs
By Lingraphica At , Princeton, 08540, Nj
Knowledge of insurance requirements regarding face-to-face documentation.
Bachelor’s Degree or equivalent combination of education and experience
Assists in eligibility and benefits inquiries when necessary.
Determines the authorization requirements of each health plan and keeps detailed records of the medical policies and requirements.
Exhibits strong problem-solving skills through both verbal and written communications.
Experience with prior authorizations, pre-determinations, and out-of-network gap exceptions.
Prior Authorization Specialist - Remote
By Orsini Pharmaceutical Services At , Elk Grove, Il
Experience with Major Medical Insurance.
Knowledge of HCPC Codes (J-Codes).
Knowledge of ICD-10 Codes (Diagnoses Codes).
Ability to convert a prescription into an authorization request based on payer requirements.
Respond to urgent emails submitted by the PCC Team or Program Manager in a timely manner.
Familiar with medical documentation such as H&P’s, Genetic testing, etc.
Rcm Specialist Authorization ( Remote)
By Help At Home At , Remote
One (1) to two (2) years' experience of revenue cycle management or billing experience in the healthcare field
Alerts the RCM Supervisor or RCM Manager regarding late or missing documents required for billing.
Strong communication skills, oral and written.
Intermediate to advanced skills with Microsoft Office Suite, especially Excel.
You are flexible and can embrace change
You value progress over perfection
Prior Authorization Audit Pharmacist
By MedImpact Healthcare Systems At , Remote
Experience in promoting disease management or drug cost management programs preferred
Three (3) to five (5) years related experience and/or training, or equivalent combination of education and experience
Analytical skills with Health Informatics experience preferred
Trains staff in PA audit requirements
Serves as the Subject Matter Expert for PA regulatory requirements that relate to assigned clients and scope of potential audits
Serves as the clinical Subject Matter Expert (SME) for all Part D audits by CMS (Centers for Medicare & Medicaid Services)
Prior Authorization Specialist Jobs
By Washington County Hospital and Clinics At , Washington, 52353, Ia
Must be proficient with computer applications necessary for effective management of all scheduling processes.
Minimum (2) years experience in an hospital setting required, prior authorization experience preferred
Knowledge of medical terminology, CPT and ICD-10 codes
Must possess excellent verbal and written communication skills as well as interpersonal skills with patients, staff and other healthcare professionals
Critical thinking skills and a positive attitude
Maintains documentation of authorization approvals and denials, including authorization numbers and associated codes, dates, and other relevant data
Authorization Specialist (Hybrid) Jobs
By BAXTER At , Saint Paul, Mn $36,000 - $90,000 a year
Experience with Total Information Management System (TIMS) a benefit
Perform verification of eligibility and benefits to determine coverage and payer requirements
Actively seek additional experience and knowledge across all functional areas to gain expertise and perform other duties and projects as assigned
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Prior Authorization Medical Clinician
By WellSense Health Plan At , Remote
Identifies members who could benefit from care management and refers to the appropriate care manager
At least 2 years of experience with pre-authorization, utilization review/management, case management, care coordination, and/or discharge planning
Demonstrated strong organization and time management skills
Experience with standard Microsoft Office applications, particularly MS Outlook, Word, Excel and other data entry processing applications
Reviews cases referred by the prior-authorization non-clinical staff according to member benefits, provider availability, and pre-determined medical necessity criteria
Utilizes critical thinking skills to identify process issues and problems, and recommend and/or implement solutions
Prior Authorization Specialist Jobs
By Commonwealth Pain & Spine At , Remote
Strong computer and phone skills, including Microsoft Office Suite experience
Works with departments and insurance companies to obtain the necessary pre-certifications, authorizations and referrals for services ordered/scheduled
Maintains a high level of understanding of insurance companies and billing authorization/referral requirements
Ensures insurance carrier documentation requirements are met and authorization documentation is scanned and documented in the patient’s medical record
Reviews and submits all follow-up authorizations, recertifications and referrals.
Exercises professional judgment and demonstrates good problem-resolution skills
Operations Supervisor, Insurance Prior Authorization (Remote Eligible)
By Cochlear Ltd At , Lone Tree, 80124, Co
Evaluate and adjust team member work and region assignments based on team member's knowledge, skill set and business need
Hybrid or remote work environment dependent on place of residence
Bachelor's Degree or Equivalent Work Experience
1‐2+ years of leadership and/or coaching experience
Extensive knowledge of government insurance and commercial insurance
Operations Supervisor, Insurance Prior Authorization (Remote Eligible)

Are you looking for a challenging and rewarding career in healthcare? We are looking for an experienced Prior Authorization Specialist to join our team! As a Prior Authorization Specialist, you will be responsible for verifying insurance coverage, obtaining prior authorizations, and ensuring accurate and timely processing of requests. If you have excellent communication and organizational skills, we want to hear from you!

Overview A Prior Authorization Specialist is responsible for obtaining authorization for medical services from insurance companies. They review patient records and medical codes to determine the necessity of services and to ensure that the services are covered by the patient’s insurance. Detailed Job Description Prior Authorization Specialists are responsible for obtaining authorization for medical services from insurance companies. They review patient records and medical codes to determine the necessity of services and to ensure that the services are covered by the patient’s insurance. They also contact insurance companies to obtain authorization for services and to verify coverage. They may also be responsible for submitting claims to insurance companies and tracking the status of claims. Job Skills Required
• Knowledge of medical terminology and coding
• Knowledge of insurance policies and procedures
• Excellent communication and customer service skills
• Ability to work independently and as part of a team
• Ability to multitask and prioritize tasks
• Attention to detail
• Computer proficiency
Job Qualifications
• High school diploma or equivalent
• Previous experience in a medical office setting
• Knowledge of medical terminology and coding
• Knowledge of insurance policies and procedures
• Ability to work independently and as part of a team
Job Knowledge
• Knowledge of medical terminology and coding
• Knowledge of insurance policies and procedures
• Understanding of medical office procedures
• Understanding of medical billing and coding
Job Experience
• Previous experience in a medical office setting
• Previous experience with insurance companies
• Previous experience with medical billing and coding
Job Responsibilities
• Obtain authorization for medical services from insurance companies
• Review patient records and medical codes to determine the necessity of services
• Contact insurance companies to obtain authorization for services and to verify coverage
• Submit claims to insurance companies and track the status of claims
• Maintain accurate records and documentation
• Answer questions from patients and providers regarding insurance coverage and authorization