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Prior Authorization Specialist – Mount Pleasant Outpatient Surgical Center
Location: Novant Health

JOB SUMMARY:

Novant Health is seeking a detail-oriented and knowledgeable Prior Authorization Specialist to join our healthcare team. In this essential role, you will manage the prior authorization process to ensure patients receive timely access to necessary medical services and treatments. The ideal candidate will have a strong understanding of medical terminology, coding, and insurance verification, allowing them to navigate complex healthcare systems efficiently and accurately.

QUALIFICATIONS:

• Proficient understanding of medical terminology.
• Previous experience in a medical office or healthcare setting preferred.
• Strong knowledge of insurance verification processes and managed care principles.
• Familiarity with medical records management and documentation standards.
• Excellent verbal and written communication skills with a strong customer service focus.
• Ability to work independently and collaboratively in a fast-paced environment.
• Detail-oriented with strong organizational skills to manage multiple tasks efficiently.
  Join Novant Health Neurology as a Prior Authorization Specialist and play a vital role in improving patient care by ensuring timely and accurate authorization of medical services.
  Novant Health is an equal opportunity employer and conducts all human resource practices in compliance with federal, state and local civil rights and employment legislation. Accordingly, Novant Health considers all applicants for employment equally, without regard to race, color, religion, sex, national origin, age, disability, veteran’s status, marital status, sexual orientation, gender identity or expression and provides them with an opportunity to progress in the organization consistent with their skills and interests

• Manage prior authorization requests for in-office procedures and other medical interventions within the Neurology department.
• Review and process prior authorization requests for medical procedures, diagnostic tests, and medications.
• Communicate effectively with healthcare providers to collect necessary documentation and information for authorization approvals.
• Verify patient insurance coverage and eligibility for requested services.
• Utilize coding knowledge, including ICD-10 and ICD-9, to ensure accurate and compliant submission of claims.
• Maintain organized and accurate medical records and documentation related to prior authorization requests.
• Collaborate with managed care organizations to resolve authorization denials or other related issues.
• Stay current on insurance policies, procedures, and industry regulations impacting prior authorizations.
• Provide exceptional customer service to patients and healthcare providers throughout the authorization process.
• Perform other duties as assigned.