Prior Auth Representative Job at Palo Verde Hematology Oncology LTD
Description:
Prior Authorizations Rep
Sun City West, AZ
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 request according to urgency
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Verify coverage and benefits and calculated any out-of-pocket portions due
- Contact patients to review any out-of-pocket portions due prior to surgery
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
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.
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