Pre-Authorization Work Comp Specialist
Pre-Authorization Work Comp Specialist
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
We are seeking a highly motivated and detailoriented individual to join our dynamic healthcare team as an Orthopaedic/Spine Preauthorization Specialist. In this position you will play a crucial role in ensuring the smooth and efficient operation of our Preauthorization or Workers Compensation Department. You will be responsible for reviewing and processingpreauthorization requests for Orthopaedic Imaging DME Surgery Pain Management and Spine procedures and treatments working closely with healthcare providers insurance companies and patients to ensure timely approvals.
Responsibilities:
- Review and evaluate preauthorization requests for orthopaedic procedures and treatments ensuring completeness and accuracy of documentation.
- Verify patient insurance coverage and eligibility for requested services.
- Collaborate with healthcare providers to gather necessary medical records and supporting documentation.
- Communicate with insurance companies to obtain preauthorization approvals or address any additional information or documentation requirements.
- Maintain accurate and uptodate records of preauthorization requests approvals and denials.
- Educate healthcare providers on preauthorization requirements and assist in resolving any preauthorizationrelated issues or concerns.
- Stay updated on insurance industry regulations policies and guidelines related to orthopaedic preauthorization.
Qualifications:
- Prior experience in orthopaedic preauthorization or medical insurance verification preferred.
- Strong knowledge of orthopaedic procedures treatments and medical terminology.
- Familiarity with insurance coding systems (e.g. CPT ICD10 and insurance claim processes.
- Excellent attention to detail and ability to analyze complex medical documentation.
- Strong communication skills both written and verbal with the ability to effectively interact with healthcare professionals insurance companies and patients.
- Proficient computer skills including experience with electronic medical record (EMR) systems and preauthorization software.
- Ability to work independently and as part of a team managing multiple priorities and meeting deadlines in a fastpaced environment.
- Commitment to maintaining patient confidentiality and adhering to HIPAA guidelines.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
