Insurance/Prior Authorization Coordinator

Description

Location:Holly Springs, Apex and Knightdale

Job title:Insurance/ Prior Authorization Specialist

Status: Full-time, Non-Exempt

Department: ECPC Pain Clinic - Administrative

Reports to:Practice Manager, ECPC Pain Clinic

Job Supervisory Responsibilities: None

Job Summary

The Insurance/ Prior Authorization Specialist is responsible for conducting prior authorizations for

medication, imaging and in office and outpatient procedures (such as MRIs and other procedures thatrequire prior authorizations), insurance verifications, and has extensive knowledge of medical programs to include Medicare and Medicaid. The ideal candidate will be great with computers, is comfortable speaking over the phone, and is an effective multi-tasker handling many different tasks on a daily basis.

Duties/Responsibilities

• Obtain, review, and request prior authorizations for various medication, imaging and other
• outpatient procedures related to pain procedures and MRIs.
• Familiar with the Appeals and Denials process.
• Verify insurance with health insurance agencies to include Medicare and Medicaid.
• Utilizes Electronic Medical Record System to obtain or document patient insurance information.
• Enter patient information accurately and per guidelines so patients can get scheduled for
• procedures or visits.
• Answers all incoming calls professionally and with a courteous and friendly attitude; assesses
• callers needs and responds in a timely manner.
• Checks patients in for their visit, and obtains necessary insurance and contact information.
• Performs other duties as assigned.
  
  

Education And Experience

• High school diploma required.
• Minimum of two years’ experience in a medical office working prior authorizations and
• insurance verifications.
• Two years’ experience with EMR systems.
• Knowledge of medical terminology and insurance plans.
  
  

Required Skills/Abilities

• Must be confident and detail-oriented.
• Must possess a professional attitude and telephone courtesy.
• Ability to prioritize and multitask in a fast paced and changing environment.
• Must be self-motivated and take initiative.
  
  

Work Environment/Physical Requirements

• Work performed in an office environment.
• Involves frequent contact with physicians, leadership, and medical office staff.
• Work may be stressful at times.
• Interaction with others is frequent and often disruptive.
  
  

ECAA is an equal opportunity employer and does not discriminate against any applicant or employee on the basis of

age, race, color, religion, sex, national origin, genetic information, disability, or other legally protected status.This policy extends to all terms, conditions, and privileges of employment, as well as the use of the Company's facilitiesand participation in all activities sponsored by the Company.