Prior Authorization Specialist - Appleton
4 days ago

Job summary
We are adding to our Prior Authorization team.As an integral member of the Clinical Services Team, the Prior Authorization Specialist is responsible for pre-authorizing ancillary testing and treatment conducted in the Neuroscience Group office and outside the office setting.
This position includes verification of insurance benefits as it applies to the precertification process and obtaining precertification/preauthorization from payors.
Responsibilities
- Collects and verifies all patient insurance information; makes changes/updates to information as needed.
- Upon receiving the anticipated procedure codes and orders from the practitioner; reviews clinical documentation for medical criteria/guidelines as identified by the insurance companies.
Job description
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