Prior Authorization Specialist

Prior Authorization Specialist needed!!!

Description:

- Verifies insurance eligibility and benefits of prospects/referrals and determines LHC rate requirements as it relates to in or out of network coverage on a daily basis in an accurate and timely manner.

-Communicates patient benefits in a timely manner using the appropriate legacy system and associated software application as found in patient notes, tasks, workflow, email, etc.

- Documents and forwards patient deductible, out-of-pocket expense, life time maximum, home health or hospice days and patient responsibility to the agency.

- Reviews and replies to branch locations urgent requests

- Obtains all authorization needed from payer for services ordered or requested

- Documents specific details related to the authorization including effective and end dates

- Serves as a liaison between the branch location and the payer on a regular basis.

- Manages work assignment to ensure all tasks and coordination notes are completed.

Skills:

Prior Authorization, Insurance Verification, medical billing, insurance follow up, epic, Healthcare, customer service, data entry

Additional Skills & Qualifications:

Candidates MUST be available to work from 8:00am - 5pm daily. They must also have the flexibility to work a 10am - 6:30pm schedule 1-2 days per week depending on staffing.

High school diploma required

Former revenue cycle experience is preferred; not required

EPIC experience is preferred; not required (translates well to their HomeCare/HomeBase system)

Excellent oral and written communication skills

Excellent organizational and analytical skills

Must be a independent and critical thinker