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Prior Authorization Representative
Location
Ohio
Posted
16 hours ago
Salary
0
Seniority
Senior
Job Description
Prior Authorization Representative
Quadax, Inc.
• Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office. • Navigate through payer portals to initiate/obtain prior authorization status. • Provide insurance company representatives with an overview of the services being submitted for prior authorization. • Answer questions regarding the reimbursement process and direct testing specific and treatment questions. • Complete LOMN (letter of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion. • Follow up with the insurance company or physician’s office as needed. • Meet benefit investigation process standards by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the task. • Participate in team meetings by sharing the details of cases worked. • Comply with all applicable SOPs. • Meet or exceed productivity and quality KPI goals. • Perform other duties as assigned.
Job Requirements
- High School diploma or GED
- Previous health insurance billing experience
- Working knowledge of medical terminology
- Proficient and attentive to details
- Excellent written and verbal communication skills
- High attention to detail
- Ability to maintain confidentiality
- Proficient in using Microsoft Excel and Word
- Ability to multitask, establish priorities, and work independently
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