What are the responsibilities and job description for the Prior authorization position at TEKsystems?
Description :
A Prior Authorization Specialist plays a critical role in managing patient care and insurance coverage. They verify insurance coverage, process prior authorization requests, and evaluate individual requests for coverage authorizations.
Specialists also interact with providers and health plans regarding utilization management and referral authorization inquiries.
This role will also have a bit of financial counselor responsibilities
- Verify medical insurance coverage for patients.
- Process prior authorization requests with accurate data entry.
- Evaluate requests for coverage authorizations based on medical necessity.
- Handle telephone calls and interact with providers and health plans.
- Set up arrangements or monthly installment plans for patients to pay off balances within hospital guidelines.
- Discuss outstanding balances with patients seeking future services.
- Make collection calls on self-pay and private pay accounts starting at 60 days without payment.
- Maintain knowledge of programs offered by the provider
Additional Skills & Qualifications :
- HS Diploma
- 2 years of prior authorization experience
- 2 years of financial navigation and counseling
Experience Level : Intermediate Level
Intermediate Level
Benefits :
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.
If eligible, the benefits available for this temporary role may include the following :
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off / Leave (PTO, Vacation or Sick Leave)
About TEKsystems :
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity.
We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia.
As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change.
That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Last updated : 2024-09-12
