Pediatrics Pre-Auth Specialist (Administration)

UAB Medicine; Birmingham (AL); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Educational assistance

Paid time off

Employee wellness programs

Paid parental leave

PSLF eligibility

Job summary

UAB Medicine is seeking a pre-authorization professional to obtain approvals for procedures and referrals. You will explain and justify test requests to insurance carriers, drawing on medical knowledge across pediatric subspecialties to establish medical necessity.

The role requires a high school diploma or GED (degree acceptable), familiarity with CPT/ICD-10/HCPCS, and 2 years in a medical setting; CPT coding or CPC is preferred.

Qualifications

• High school diploma or GED; degree can substitute for experience.
• Extensive knowledge of medical terminology and abbreviations; CPT/ ICD-10/HCPCS familiarity.
• Two years’ experience in a medical setting, quality/utilization review experience preferred.

Responsibilities

• Obtain pre-authorization for procedures and referrals required by insurance companies.
• Provide explanation and justification of requested tests and referrals to carriers and PMP offices.
• Maintain knowledge of pediatric subspecialties to determine medical necessity for testing and referrals.

Skills

Medical terminology

Documentation

Attention to detail

Education

High school diploma or GED

CPC certification preferred

ICD-10 coding certificate preferred

Tools

EMR

Windows

Word

Excel

Job description

UAB Medicine is seeking a pre-authorization professional to obtain approvals for procedures and referrals. You will explain and justify test requests to insurance carriers, drawing on medical knowledge across pediatric subspecialties to establish medical necessity.

The role requires a high school diploma or GED (degree acceptable), familiarity with CPT/ICD-10/HCPCS, and 2 years in a medical setting; CPT coding or CPC is preferred.