Prior Authorization Specialist at Artisan Design Group, LLC

Conway, Arkansas, United States -

Full Time

Start Date

Immediate

Expiry Date

16 Jun, 26

Salary

0.0

Posted On

18 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Coordination, Documentation Accuracy, Customer Service, Prior Authorization, Referral Process, Communication, Writing Skills, Data Entry Accuracy, Relationship Building, Problem Solving, Insurance Verification, Compliance, Organization, Multi-tasking

Industry

Description

Description PRIOR AUTHORIZATION REPRESENTATIVE: The description below is intended to depict the general content and requirements for the performance of this position. It is not to be constructed as an exhaustive statement of duties, responsibilities, or requirements. JOB SUMMARY: The Prior Authorization Representative’s primary job function is coordinating transition services with internal and external partners to ensure the accuracy and completeness of all required documentation is of the highest quality whole providing exceptional customer service. The employee will promptly, efficiently and accurately execute all aspects of back office duties including the prior authorization and referral process in accordance with regulatory requirements in a timely manner and keep patient and provider informed when there are delays or denials from insurance or by provider referred to communicate all resolutions f appropriate. Excellent communication and legible writing skills are required to ensure data entry accuracy. This position is responsible for building strong, positive relationships with patients and other health care facilities. This position requires processing and completing an average of 15-30 prior authorizations daily. MINIMUM QUALIFACTIONS: · Must have a High School diploma or equivalent · Knowledge of medical terminology/procedures and human anatomy preferred. · Must have strong organization and multi-tasking skills. · Must be able to work well with others or alone, under minimal supervision, and meet strict deadlines. RESPONSIBILTY/DUITES: · Understand and execute the principles of Prior Authorization to facilitate the right care at the right time in the right setting. · Able to solve complex prior authorization questions and issues. · Ensures quality and accuracy of the patient’s insurance information and that listed certification periods, billing addresses, policy numbers, authorization numbers, ect. Are all entered correctly. · Prioritizes and processed incoming insurance verifications and prior authorization requests. · Obtain authorizations from patient’s private/commercial or managed health care insurance and all other payor sources requiring authorization via telephone, faxes or online systems while maintaining compliance to medical record confidentiality regulations. Requirements MINIMUM QUALIFACTIONS: · Must have a High School diploma or equivalent · Knowledge of medical terminology/procedures and human anatomy preferred. · Must have strong organization and multi-tasking skills. · Must be able to work well with others or alone, under minimal supervision, and meet strict deadlines.

Responsibilities

The primary function involves coordinating transition services with internal and external partners to ensure high-quality, accurate, and complete documentation while executing back-office duties like the prior authorization and referral process efficiently. This role requires keeping patients and providers informed about delays or denials and building positive relationships with patients and healthcare facilities.