Prior authorization

Mediabistro
East Stroudsburg, PA Full Time
POSTED ON 5/2/2024 CLOSED ON 5/6/2024

What are the responsibilities and job description for the Prior authorization position at Mediabistro?

Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission

of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers;

and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.The Practice Prior Authorization and Referral Specialist is responsible for the coordination of prior-authorizations and referral process forpatients being referred for specialty care, medications, and diagnostic procedures.

The specialist will secure the necessary prior authorization, then notify the patient aiding in thecoordination of patient care

JOB DUTIES AND RESPONSIBILITIES : Receive request for patient requiring specialty care through the electronic health record (EHR), direct order by provider communication, phone, and / or fax.

Reviews patient insurance information and eligibility / verification to obtain prior authorization for specialty care and / or services.

Obtain prior authorization from insurance companies prior to services being ordered and / or rendered.Documents in EHR prior authorization approval to ensure proper reimbursement.

Responds to written as well as telephone inquires from patients, insurances, pharmacies, other outpatient / inpatient departments, and facilities regarding planned specialty care and / or services.

Stoops, bends, and reaches above shoulder level to retrieve needed materials. Prior authorization experience preferred.TRAINING AND EXPERIENCE : One to two years of experience in medical billing, a medical office or insurances preferred.

Working knowledge of medical office procedures as well as detailed understanding of ICD 10 and CPT codes. Knowledge of regulatory standards and compliance requirements.

Please complete your application using your full legal name and current home address. It is highly recommended that you create a profile at the conclusion of submitting your first application.

Last updated : 2024-05-02

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