Healthcare Prior Authorizations Specialist

1 week ago

kollam, India beBeeProfessional Full time

As a skilled and detail-oriented professional, we are seeking an individual to collaborate with our healthcare team as a Prior Authorizations Coordinator.Key Responsibilities:Medical Record Review: Conduct thorough reviews of patient medical records to determine the necessity of prior authorizations for various procedures and treatments.Communication: Effectively communicate with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.Documentation and Compliance: Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.Follow-up and Issue Resolution: Follow up on pending authorizations and resolve any issues that may arise during the approval process.Industry Knowledge and Training: Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).Team Collaboration: Collaborate with medical office staff to ensure seamless patient care and efficient processing of authorizations.Patient Education: Educate patients on the prior authorization process and any necessary steps they need to take.Sleep Study Authorization: Process sleep study authorizations for both in-lab and home sleep studies.Additional Responsibilities Include: Sleep consultations, sleep study appeals, and oral appliance referrals.As a successful candidate, you will possess: excellent communication skills, strong analytical abilities, and a passion for delivering exceptional customer service.

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