DOCS Dermatology Group
Prior Authorization Specialist
DOCS Dermatology Group – 2,000+ providers across 100+ locations in 10 states.
Job Overview The Prior Authorization Specialist ensures efficiency and accuracy of our billing process, directly impacting patient experience.
Responsibilities
Streamline and secure pre-certification, medical authorization, and referral processes, ensuring compliance with insurance requirements.
Coordinate with insurance entities, review boards/organizations, and clinical contacts for effective communication and benefit determination.
Establish positive rapport with employees, patients, physicians, and vendors utilizing written and verbal communication methods.
Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients.
Ensure timely and accurate insurance authorizations and conduct medical benefits investigations.
Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
Initiate patient education on available assistance programs.
Document information, responses, and status updates in the Electronic Medical Record (EMR) system.
Qualifications
High school diploma or equivalent.
1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice.
Knowledge of Medicare/Medicaid and major insurance carrier guidelines.
Working knowledge of ICD-9-10 medical coding and billing and medical terminology.
Physical demands: frequently sit, stand, walk, talk, use computers, phones, iPads; use close vision; occasionally stoop, bend, reach; lift up to 25 pounds.
Benefits
Medical, dental, and vision insurance
401k matching
Company-paid life insurance
Employee assistance program
Paid time off
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
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Job Overview The Prior Authorization Specialist ensures efficiency and accuracy of our billing process, directly impacting patient experience.
Responsibilities
Streamline and secure pre-certification, medical authorization, and referral processes, ensuring compliance with insurance requirements.
Coordinate with insurance entities, review boards/organizations, and clinical contacts for effective communication and benefit determination.
Establish positive rapport with employees, patients, physicians, and vendors utilizing written and verbal communication methods.
Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients.
Ensure timely and accurate insurance authorizations and conduct medical benefits investigations.
Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
Initiate patient education on available assistance programs.
Document information, responses, and status updates in the Electronic Medical Record (EMR) system.
Qualifications
High school diploma or equivalent.
1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice.
Knowledge of Medicare/Medicaid and major insurance carrier guidelines.
Working knowledge of ICD-9-10 medical coding and billing and medical terminology.
Physical demands: frequently sit, stand, walk, talk, use computers, phones, iPads; use close vision; occasionally stoop, bend, reach; lift up to 25 pounds.
Benefits
Medical, dental, and vision insurance
401k matching
Company-paid life insurance
Employee assistance program
Paid time off
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
#J-18808-Ljbffr