Remote Practice Prior Authorization and Referral Specialist, Gastroenterology

Overview

The Practice Prior Authorization and Referral Specialist is responsible for coordinating prior authorizations and referrals for patients needing specialty care, ensuring proper documentation and communication with insurance providers and patients.

In Short

• Coordinate prior authorizations and referrals for specialty care.
• Perform insurance verification and obtain pre-authorizations.
• Document prior authorization approvals in EHR.
• Respond to inquiries from patients and insurance companies.
• Work collaboratively with other departments.
• Review and follow up on authorization and claim denials.
• Notify providers of prior authorization denials.
• Maintain accurate patient demographic and insurance information.
• Handle requests through EHR, phone, and fax.
• Other duties as assigned.

Requirements

• High school diploma or equivalent required.
• 1-2 years of experience in medical billing or a medical office preferred.
• Knowledge of medical office procedures and insurance processes.
• Familiarity with ICD 10 and CPT codes.
• Understanding of regulatory standards and compliance requirements.
• Strong communication skills.
• Ability to work independently and in a team.
• Proficient in EHR systems.
• Detail-oriented with strong organizational skills.
• Ability to manage multiple tasks simultaneously.

Benefits

• Competitive salary.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Flexible working arrangements.
• Employee assistance programs.
• Retirement savings plan.
• Paid time off and holidays.
• Recognition and rewards programs.
• Commitment to employee well-being.