Prior Authorization Specialist

2 weeks ago


kurnool, India beBeeAuthorization Full time

Job OverviewWe are seeking a skilled and detail-oriented Prior Authorization Specialist to support our healthcare operations.Key Responsibilities:Analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.Follow up on pending authorizations and resolve any issues that may arise during the approval process.Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).Collaborate with medical office staff to ensure seamless patient care and efficient processing of authorizations.Educate patients on the prior authorization process and any necessary steps they need to take.Prioritize sleep study authorizations, consultations, and appeals processes for timely and effective outcomes.Develop and maintain a thorough understanding of oral appliance referral processes.Requirements and Qualifications:To succeed in this role, you should possess strong analytical and communication skills. A background in health administration or a related field is beneficial. Proficiency in electronic health record systems and medical coding practices (ICD-10) is essential. Additionally, you must be able to work independently and as part of a team, prioritizing tasks and managing time effectively to meet deadlines.



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