Physical Rehabilitation Network
Authorizations Representative
Physical Rehabilitation Network, Dallas, Texas, United States, 75215
Overview
Location:
REMOTE Candidate MUST be located in one of the following states:
AR, AZ, CA, CO, DE, FL, GA, IA, ID, IL, KY, MD, MI, MN, MO, MT, NC, ND, NM, NV, NY, OK, OR, RI, SD, TN, TX, VA, WA, WI, WY Schedule:
Full time (M-Fr 8am-4:30pm PST) Pay:
$21/hr Position Summary:
The Authorization Representative is responsible for obtaining, verifying, and documenting insurance authorizations and pre-certifications for medical procedures, services, or medications. This role ensures compliance with payer requirements, prevents claim denials, and supports efficient patient access to care. Key Responsibilities
Insurance Verification & Authorization Secure prior authorizations and pre-certifications from insurance companies within required timeframes. Review medical necessity guidelines and payer policies to determine required documentation. Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval. Documentation & Data Entry Accurately document authorization numbers, effective dates, status updates, and payer information in electronic health record (EHR) or practice management systems. Maintain organized and compliant records according to HIPAA standards. Communication & Coordination Provide updates to scheduling, billing, and clinical teams regarding authorization status. Collaborate with clinical teams to support appeals or additional documentation requests. Compliance & Quality Assurance Adhere to federal, state, and payer-specific regulations. Monitor policy changes from insurance carriers and notify internal teams as needed. Assist in resolving claim denials related to missing or incorrect authorizations. Skills & Qualifications
Required: High school diploma or equivalent (some employers prefer an associate degree in healthcare administration or related field). Experience in healthcare authorization, medical billing, patient access, or insurance verification. Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations. Excellent communication, organization, and problem-solving skills. Proficiency with EHR systems, payer portals, and standard office software. Preferred: Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans). Core Competencies
Attention to detail Ability to work in a fast-paced environment Time management Critical thinking and decision-making
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Location:
REMOTE Candidate MUST be located in one of the following states:
AR, AZ, CA, CO, DE, FL, GA, IA, ID, IL, KY, MD, MI, MN, MO, MT, NC, ND, NM, NV, NY, OK, OR, RI, SD, TN, TX, VA, WA, WI, WY Schedule:
Full time (M-Fr 8am-4:30pm PST) Pay:
$21/hr Position Summary:
The Authorization Representative is responsible for obtaining, verifying, and documenting insurance authorizations and pre-certifications for medical procedures, services, or medications. This role ensures compliance with payer requirements, prevents claim denials, and supports efficient patient access to care. Key Responsibilities
Insurance Verification & Authorization Secure prior authorizations and pre-certifications from insurance companies within required timeframes. Review medical necessity guidelines and payer policies to determine required documentation. Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval. Documentation & Data Entry Accurately document authorization numbers, effective dates, status updates, and payer information in electronic health record (EHR) or practice management systems. Maintain organized and compliant records according to HIPAA standards. Communication & Coordination Provide updates to scheduling, billing, and clinical teams regarding authorization status. Collaborate with clinical teams to support appeals or additional documentation requests. Compliance & Quality Assurance Adhere to federal, state, and payer-specific regulations. Monitor policy changes from insurance carriers and notify internal teams as needed. Assist in resolving claim denials related to missing or incorrect authorizations. Skills & Qualifications
Required: High school diploma or equivalent (some employers prefer an associate degree in healthcare administration or related field). Experience in healthcare authorization, medical billing, patient access, or insurance verification. Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations. Excellent communication, organization, and problem-solving skills. Proficiency with EHR systems, payer portals, and standard office software. Preferred: Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans). Core Competencies
Attention to detail Ability to work in a fast-paced environment Time management Critical thinking and decision-making
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