Description
Home Search Jobs Job Description Customer Service Representative Contract: Connecticut, Connecticut, US Salary Range: 20.00 - 21.00 | Per Hour Job Code: 364353 End Date: 2025-09-07 Days Left: 21 days, 3 hours left Apply Pay Range: $20/hr-$21/hrBenefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, dental insurance, vision insurance, 401(k) retirement plan, life insurance, long-term disability insurance, short-term disability insurance, paid parking/public transportation, (paid time , paid sick and safe time , hours of paid vacation time, weeks of paid parental leave, paid holidays annually - AS Applicable) About the Role
- The Prior Authorization Representative plays a crucial role in ensuring patients have access to necessary therapies by verifying and obtaining prior authorizations.
- This position involves direct communication with physician offices and payers to facilitate patient access to treatments.
- The representative will manage patient insurance coverage, identify prior approval requirements, and handle authorization submissions.
- Additionally, the role includes assisting with appeals for prior authorization denials and managing special cases.
Responsibilities
- Validate patient insurance coverage and communicate any issues with benefits or coverage to relevant parties.
- Check and initiate prior authorization requirements as needed.
- Coordinate and submit necessary paperwork, clinical notes, and forms to support authorization requests.
- Frequently follow up to ensure visibility on authorization status throughout the approval process.
- Maintain a basic understanding of payer payment processes and detailed knowledge of payer prior authorization processes.
- Familiarity with ICD9/10 and CPT codes, with expert knowledge of specific therapy codes.
- Provide superior customer service and communication with various stakeholders, including physicians, sales representatives, payer representatives, and utilization reviewers.
Education Qualification
- Relevant educational background in healthcare administration, medical billing, or a related field is preferred.
Job Requirement - medical billing
- prior authorization
- ICD9/10 and CPT
Reach Out to a Recruiter Apply Now