Pre-Authorization Specialist

Job Description

Job Description

Description :

• Must be local to Austin / the surrounding area

Pre-Authorization Specialist Job Purpose : The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient and ancillary services. The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

DUTIES INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING :

Requirements : SUPERVISION :

Pre-Authorization Manager

MINIMUM QUALIFICATIIONS :

Education :

Requires a high school diploma or GED

Experience :

Minimum of three years’ experience in billing / pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including : Medicare, Medicaid, HMO’s and PPO’s required.

WORKING CONDITIONS :

Environmental Conditions :

Physical Conditions :