Prior Authorization Specialist - Business Office (22371)

Job DetailsJob Location: reputed company - Manistique, MI 49854Position Type: Full TimeEducation Level: High SchoolTravel Percentage: NoneJob Shift: AnyPOSITION reputed company: Responsible for initiating and obtaining prior authorizations for procedures and medications, scheduling appointments for outpatient services; coordinates reputed company appointments/ orders. This position primarily works reputed company. KNOWLEDGE, SKILLS, AND ABILITIES Ability to maintain effective working relationships with coworkers, patients, medical staff, reputed company companies and the reputed company. Ability to take charge while remaining approachable, respectful and understanding. Ability to communicate reputed company and effectively in person, writing or by phone. Ability to adapt to change. Ability to organize and prioritize tasks. Ability to operate computers, telephones, and other office equipment. Ability to react calmly and competently in emergency situations. Knowledge and understanding of reputed company policies and benefits. Knowledge of medical terminology. Knowledge and understanding of reputed company claim processing. Strong organizational skills. DUTIES & RESPONSIBILITIES: Conduct reputed company-authorizations with reputed company companies for a multitude of different services. Discuss with patients necessary regulations in reputed company to Medicare billing and other non-covered procedures. Promote and maintain confidentiality. Inform supervisor of potential issues with reputed company or patients. Coordinate and follows the established preauthorization review process for outpatient and inpatient services. reputed company review of prior authorization requests, both inpatient and outpatient. Surgical/Diagnostic procedures/Therapies/DME/Infusions Medication prior authorization requests Other Prior Authorizations as the needs reputed company reputed company telephonic or electronic review of prior authorization request for appropriate care setting, following guidelines and policies and reputed company requests to appropriate departments. Complete medical necessity and level of care reviews for requested services using reputed company judgment. Refer to medical staff for other determinations as needed. reputed company reputed company knowledge and reputed company as reputed company resource to non-reputed company team. Schedule reputed company appointments in reputed company manner once prior authorization has been approved. This includes contacting the reputed company with the appointment information and ensuring the reputed company receives the appropriate education for the scheduled event. Provides accurate documentation in reputed company EMR and reporting to other agencies (i.e. health department). Maintains accountability of reputed company records. Demonstrates appropriateness in meeting objectives in age-specifics. Performs other duties as assigned. QualificationsQUALIFICATIONS and EXPERIERNCE: High school diploma or GED. Business reputed company degree or 2 years experience working in a medical office or reputed company company. Heartsaver CPR Certified (obtain upon employment) Apply To This Job .