Job Description: We are seeking a detail-oriented and highly organized Prior Authorization Specialist to join our team.
In this role, you will be responsible for ensuring that patients receive the necessary approvals for medical services, medications, and procedures, while maintaining compliance with insurance requirements and company policies.
-Full On-Site in El poblado -Monday to Friday - Weekends off - 9am - 6pm Other benefits: Productivity and attendance bonuses Loyalty bonus (every 6 months) Discounts in selected stores Growing opportunities Smarfit Black free (Gym membership) Birthday off Key Responsibilities: Process and submit prior authorization requests to insurance companies and payers in a timely and accurate manner.
Verify patient insurance coverage and obtain pre-certifications for services as required.
Collaborate with healthcare providers and clinical staff to gather and provide necessary documentation.
Follow up on submitted prior authorizations to ensure timely responses from payers.
Communicate authorization outcomes to patients, providers, and relevant team members.
Maintain detailed and accurate records of authorization processes and outcomes in the electronic medical record (EMR) system.
Stay updated on changes in insurance policies, coverage guidelines, and prior authorization requirements.
Address denials by initiating appeals and providing additional documentation as needed.
Provide exceptional customer service to patients, providers, and team members.
Requirements: Previous experience in prior authorizations, medical billing, or insurance verification is required.
Strong understanding of medical terminology, coding (CPT, ICD-10), and healthcare insurance processes.
Proficient in using EMR systems and other healthcare-related software.
Excellent communication and interpersonal skills.
High attention to detail and ability to multitask in a fast-paced environment.
Strong problem-solving skills and ability to navigate complex insurance processes.
Job Type: Full-time Application Question(s): Do you live in Medellín or its surroundings?
Language: advanced english (Required) #J-18808-Ljbffr