Eligibility and Prior Authorization Specialist
- Verify patient insurance benefits and coverage for OBGYN services in clinic.
- Obtain prior authorizations and pre-certifications for treatments as required by insurance providers.
- Communicate with insurance companies, patients, and healthcare providers to resolve any authorization or benefits-related issues.
- Maintain accurate records of authorizations, approvals, and denials in the electronic health record (EHR) system.
- Educate patients about their insurance benefits, coverage limitations, and out-of-pocket costs.
- Work closely with the billing department to address claim denials related to authorization issues.
- Stay up to date with insurance policies, coding changes, and payer requirements.
- Provide administrative support to the practice as needed, including scheduling and coordinating patient services.
- Minimum of 1 year of experience in completing prior authorization for a medical facility; PREFERRED in an OBGYN or women’s health setting.
- Medical Assistance experience PREFERRED
- Strong understanding of insurance policies, prior authorization processes, and medical billing.
- Proficiency in electronic health records (EHR) preferably AthenaOne.
- Excellent communication and customer service skills.
- Strong attention to detail and ability to work efficiently in a fast-paced environment.
- Salary based on experience
- Health, dental, and vision insurance
- Life insurance
- 401(k) with employer matching after 1 year of service
- Paid time off (PTO) and holidays
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