Prior Authorization Representative I

Essential Functions:

• Verifies insurance eligibility, benefits, network status, and creates pre-service liability estimate.
• Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
• Secures prior authorizations for outpatient imaging and in office scheduled services.

Knowledge/Skills/Abilities:

• Basic knowledge of accounting, word processing, and spreadsheets.
• Ability to work independently within a team setting.
• Ability to adapt to a dynamic work environment.

Qualifications:

• Two years of experience in a health care financial setting, or the equivalency.
• Previous experience with medical insurance and prior-authorizations.
• ICD/CPT coding experience.