Prior Authorization Specialist

Our dynamic and growing healthcare organization is committed to providing high-quality medical services to our patients. We're seeking a skilled and detail-oriented Prior Authorization Specialist to join our team and play a crucial role in ensuring smooth healthcare operations.

Responsibilities:

• Review and process prior authorization requests from medical providers, ensuring all necessary documentation is complete and accurate. 

• Communicate with insurance companies, medical providers, and patients to gather required information and resolve any discrepancies.

• Collaborate with healthcare professionals to ensure compliance with insurance guidelines and regulations.

• Maintain thorough and up-to-date knowledge of insurance policies, coding, and billing requirements.

• Document all authorization activities accurately and maintain organized records for auditing purposes.

• Assist in training and educating staff on prior authorization processes and best practices.

• Identify opportunities for process improvement and contribute to enhancing overall efficiency.

Qualifications:

• Proven experience as a Prior Authorization Specialist or similar role in a healthcare setting.

• Strong understanding of medical terminology, CPT and ICD-10 codes, and insurance procedures.

• Excellent communication skills, both written and verbal, for effective interactions with team members, providers, and insurance representatives.

• Detail-oriented with the ability to analyze complex information and make informed decisions.

• Proficiency in using HER/EMR software. 

• Exceptional organizational skills and ability to manage multiple tasks simultaneously.

• Understanding of HIPAA regulations and commitment to maintaining patient confidentiality.

• High school diploma or equivalent

Details:

• Schedule: Monday – Friday | 8:30am – 5:00pm

Job Type & Location

This is a Contract to Hire position based out of Wallingford, CT.