Prior Authorization Specialist - Manchester, United States - NH Eye Associates

NH Eye Associates

Verified Company

Manchester, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

POSITION:
Prior Authorization Specialist

DEPARTMENT:
Billing Department/Surgical Department

REPORTS TO:
Billing Manager

TRAVEL REQUIRED:
N/A

Job Summary:

This individual is responsible for initiating, resolving, and following through on insurance prior authorizations for medications and procedures within the practice.

EXPERIENCE:

Related associate degree or experience _preferred._
Experience in a healthcare setting and medical terminology _required. Ophthalmology preferred._
Computer and accurate data entry skills.

Essential Skills and Abilities:

Experience in accurate data entry.
Requires attention to detail, strong organization skills and commitment to collaborating and problem solving.
Exceptional phone and communication skills.
Ability to work with frequent interruptions and respond appropriately to unexpected situations.
Ability to interact with physicians and staff and participate as a team member with individuals inside and outside the department.

Responsibilities:

Verify patients' insurance coverage in a timely manner.
Initiate insurance prior authorization for injectable medications, surgeries, in office procedures.
Obtains insurance benefits and translates for qualification.
Follow up on status of authorization though various insurance portals or via telephone.
Follows up on missing or inaccurate information.
Assess accounts for accuracy.
Enrolls patients in various assistance programs for payment.
Ensures documentation is accurate in patients records.
Appeal insurance companies after denials.
Communicates with the team and patients regarding statuses.
Performs annual reverification process for applicable patients.