Position Type Full Time
Job Shift Day
Category Health Care

Description

SUMMARY

Determines which patient services have third party payor requirements and is responsible for verifying eligibility, obtaining insurance benefits and ensuring prior authorization requirements are met prior to the delivery of tests, treatments, and medications

DUTIES/RESPONSIBILITIES (include but are not limited to the following)


+ Reviews and processes all assigned prior authorization requests to completion. Diligently reviews patient health care data, diagnostic testing and treatment information for completeness for insurance requirements and prior authorization process.

+ Communicates with providers, and clinical staff as needed to obtain and understand clinical documentation requirements. Provide required clinical documentation to payers via phone, faxed forms, and/or website.

+ Maintains documentation of authorization a...