Job Description

Overview
Under the direct supervision of the Customer Care Manager , the Prior Authorization Specialist is responsible for obtaining pre-authorizations for medications and diagnostics, scheduling patients for outpatient testing and coordinating patient orders.
Candidate Qualifications
Licensure/Certification: None
Education: High School Diploma Required
Experience: Previous experience in a clinic setting preferred.
Knowledge/Skills: Must have excellent verbal and written communication skills. Requires effective customer relation skills, ability to organize and interpret data. Requires good judgment, tact, diplomacy, and ability to problem solve. Able to work effectively in a team environment. Able to use a personal computer and related software.
Minimum Qualifications: Must be able to sit, stand and walk for long periods of time. Able to read and understand the English language. Able to effectively maintain confidentiality of records and communicate with all levels of personnel.
Job Responsibilities
Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
Request, track and obtain prior authorization from insurance carriers within time allotted for medical services.
Request, follow up and secure prior authorizations prior to services being performed.
Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
Communicate any insurance changes or trends among team.
Maintains a level of productivity suitable for the department.
Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
Other duties as assigned.
Kintegra Health Core Requirements
Patient First – An approach to care that holds primary, the well-being and desires of the patient
Build not Blame – Focusing first on finding fault with the process rather than the person
Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers
C ooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description
Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.

Job Tags

Work at office,

Similar Jobs

ProPivotal

Employer Relations Recruiter - Financial Services Job at ProPivotal

...meaningful relationships that connect top early-career talent with leading organizations in investment banking, asset management, hedge funds, and more Collaborative Environment: Join a small, supportive team that values partnership, innovation, and results...

Aspire Public Schools

Biology Teacher Job at Aspire Public Schools

...secondary lives. Every day, our community of students, families, teachers and staff comes together to learn, work, and play in an... ...Bachelors degreeCalifornia teaching authorization in single subject Biology required1+ year working with students as a teacher, teacher...

Aspire Lifestyles

Customer Service Representative Job at Aspire Lifestyles

...Job Description Job Description Customer Service Representative (Remote) Location: Ontario, Canada Company: Aspire Lifestyles Americas, Inc. Start Date: September 22, 2025. Location Requirement : MUST be located in Ontario, Canada Job description:...

Smart IT Frame LLC

RN Case Manager Job at Smart IT Frame LLC

...Job Description RN Case Manager Facility: Santa Fe Service Unit (PHS Indian Hospital) Location: Santa Fe, NM 87505 Assignment... ...regulations Additional Details Facility is located in a remote area on the reservation , with limited housing options ....

CorVel

Content Marketing Associate Job at CorVel

We are seeking a talented and motivated Content Marketing Associate to join our marketing team. The ideal candidate will understand content strategies and create engaging content that drives brand awareness and customer engagement. This role is for a self-starter who can...

Prior Authorization Specialist Job at Kintegra Health, Gastonia, NC

a21ESCtQQk1zdUptQk1XZTVSdFBNWEg5T3c9PQ==