Job Title: Full-Time Prior Authorization Representative
Company: The Spine Institute
Job Summary:
The Spine Institute is seeking a skilled Full-Time Prior Authorization Representative to join our healthcare team! This position is crucial in ensuring that patients receive the necessary medical services and procedures by facilitating the authorization process with insurance companies. The ideal candidate will be knowledgeable about insurances, payer websites, medical terminology, and the prior authorization process (experience with radiology and spine procedure authorizations is a plus) .
Key Responsibilities:
- Review and process prior authorization requests for radiology orders and in-office spine injections in a timely manner.
- Communicate effectively with healthcare providers, insurance companies, and patients to gather necessary information and clarify authorization requirements.
- Assess clinical documentation and medical necessity to determine compliance with insurance guidelines.
- Maintain detailed records of authorization requests and their outcomes, documenting all communication and follow-ups in the electronic health record (EHR) system (experience working with Advanced MD is a plus).
- Monitor pending authorization requests, ensuring timely responses from insurance companies, and escalate issues as needed.
- Experience in a prior authorization role is required.
- Strong understanding of insurance processes, medical terminology, and payer websites (Availity, Carelon, Evicore, etc) .
- Excellent communication skills, both written and verbal.
- Strong organizational skills and attention to detail, with the ability to manage multiple tasks and deadlines effectively.
- Ability to work independently.
Benefits:
- Competitive salary
- Health, dental, and vision insurance
- 401(k) with company match
- Paid time off (PTO) and holidays
How to Apply:
Please submit your resume with details about your relevant experience.
The Spine Institute is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
...A Smile To Grow Withis looking for a full time Patient Advocate to join their team! We are an exceptional, fast paced dental office that seeks to provide the highest level of dentistry to each and every one of our valued patients. We pride ourselves on being a dental...
We are seeking a highly motivated, proactive, and detail-oriented Inventory & Archive Assistant to join our team. This individual will play a key role in maintaining and organizing an extensive archive and inventory of products. Based predominantly in Glendale, the role...
...Urology Physician Assistant -Augusta, GA Job#16663660 Join a respected multispecialty clinic in Eastern Georgia delivering high-quality urology care and patient-focused services. Manage patient care, perform office procedures, and collaborate with physicians to...
...****@*****.*** Minimum Application Requirements Qualification: Minimum Qualification Requirement:Degree in Mathematics with a Teaching Qualification Experience: 2 Years Type of Staff: Male or Female can apply to this job...
...Essential Functions Must properly handle chemicals and cleaning compounds using personal protective equipment and following proper safety guidelines. Ensures that all work areas are maintained keeping them clean and safe in accordance with sanitary, safety, and...