Prior Authorization Representative

We are in search of a highly organized and detail-oriented Prior Authorization Representative to join our team. As a prior authorization representative, you will play a crucial role in our healthcare organization, ensuring that our patients receive necessary procedures and treatments efficiently and seamlessly. If you have experience in the healthcare or health insurance field and are ready to take on a challenging and rewarding role, we invite you to apply.

Responsibilities:

-        Follow the company's values, vision, and mission.

-        Evaluate medical documentation to determine prior authorization eligibility based on established criteria.

-        Collaborate with healthcare providers to gather additional information when necessary.

-        Serve as a point of contact for patients, explaining the prior authorization process and addressing their inquiries.

-        Verify patient eligibility in accordance with insurance policy terms.

-        Prepare and submit prior authorization requests, including all required documentation.

-        Follow up on requests and resolve any issues that may arise during the process.

-        Collaborate with other internal departments to ensure efficient coordination in prior authorization management.

-        Maintain detailed records of all requests and related communications.

-        Other duties as required.