Job Overview
We are seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. The ideal candidate will play a crucial role in ensuring that patients receive the necessary medical services and treatments by managing the prior authorization process effectively. This position requires a strong understanding of medical terminology, insurance processes, as well as excellent communication skills.

Duties

• Review and process prior authorization requests for medical services and procedures.
• Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
• Ensure compliance with HIPAA regulations while handling sensitive patient information.
• Maintain organized medical records and documentation related to prior authorizations.
• Collaborate with clinical staff to verify the medical necessity of requested services.
• Follow up on pending authorizations and resolve any issues that may arise during the approval process.
• Stay updated on managed care policies and changes in insurance requirements.

Qualifications

• Proven experience in a medical office setting, preferably in a role related to prior authorizations or insurance verification.
• Strong knowledge of medical terminology, and managed care processes.
• Familiarity with medical records management and office procedures.
• Excellent organizational skills with attention to detail.
• Strong communication skills, both verbal and written, to effectively interact with patients, providers, and insurance representatives.
• Ability to work independently as well as part of a team in a fast-paced environment.
• Understanding of HIPAA regulations regarding patient privacy and confidentiality.

If you are passionate about supporting patient care through efficient authorization processes and have the required qualifications, we encourage you to apply for this essential role in our organization.

Job Type: Part-time

Expected hours: 16 – 24 per week

Application Question(s):

• Advocare, LLC requires all employees to have a background check and a drug screening.

Are you willing to have these done?

Education:

• High school or equivalent (Required)

Experience:

• Prior Authorization: 1 year (Required)

Language:

• English (Required)

Work Location: In person