Prior Authorizations Rep at GI Alliance

Description

Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals throughout Arizona.

• Review EMR chart messaging and review schedules daily for upcoming surgical & in-office procedures
• Review chart documentations to ensure patient meets medical policy guidelines
• Prioritize authorization requests according to urgency
• Obtain authorization via payer website or by phone and follow up regularly on pending cases
• Verify coverage and benefits and calculate any out-of-pocket portions due
• Contact patients to review any out-of-pocket portions due prior to surgery
  
  

Qualifications

Requirements

• Minimum 1 year prior authorization experience
• Understanding of payer medical policy guidelines to manage authorizations effectively
• Proficient use of CPT and ICD10 codes
• Detail-oriented and above-average organizational skills
• Plans and prioritizes to meet deadlines
• Ability to multitask and remain focused while managing a high volume, time-sensitive workload
• Urology experience helpful
  
  

Requirements

Physical Requirements:

Requires sitting for extended periods. Some bending, stretching, and stooping required. Manual dexterity enough to use a keyboard and calculator. Normal range of hearing and vision and verbal communication is required. Use of a telephone is required.

Performance Requirements:

Knowledge of billing and insurance practices and procedures as well as regulations including Medicare, Medicaid, and third-party insurance companies including managed care contracts. Knowledge of current ICD-10 and CPT codes is required. Strong communication skills are required.