Prior Authorization and Scheduling Representative

Trinity Employment Specialists; Tulsa (OK); On-site; USD 23,000 - 26,000; Full time

Job summary

Trinity Employment Specialists in Tulsa, OK is seeking a detail-oriented Prior Authorization and Scheduling Representative for an onsite role. The position focuses on securing authorizations for special studies and coordinating scheduling with patients and clinical teams.

The ideal candidate will understand medical terminology, CPT codes, and payer-specific pre-certification requirements, ensuring accurate eligibility verification and documentation.

Qualifications

• Familiarity with medical terminology, CPT codes, healthcare authorization, and scheduling processes.
• Strong analytical, organizational, and data management skills.
• Proficiency in using payer-specific websites, tools, and scheduling software.

Responsibilities

• Obtain Prior Authorizations: Secure necessary authorizations for special studies from insurance carriers using carrier-specific tools and systems.
• Maintain Pre-Certification Knowledge: Keep current with each payer's pre-certification requirements via payer websites and resources.
• Clinical Data Analysis: Evaluate and interpret clinical data in relation to authorization requests, cross-referencing terms, diagnoses, and CPT codes for compliance.
• Eligibility & Benefits Verification: Confirm eligibility and benefits for each special study, ensuring accurate processing.
• Scheduling Coordination: Arrange appointments for authorized studies, coordinating with patients and clinical teams to optimize scheduling.
• Documentation: Enter and maintain notes in the practice management system regarding referrals, authorizations, studies, and scheduling.

Skills

Medical terminology

CPT codes

Healthcare authorization

Scheduling processes

Analytical skills

Organizational skills

Data management

Tools

Payer websites/tools

Scheduling software

Job description

Prior Authorization and Scheduling Representative (onsite position, not remote)

Location: Tulsa, OK

Schedule: Monday - Friday, 8:00 AM - 5:00 PM

Compensation: Based on Experience ($17.00 - $19 per hour)

Position Overview

We are seeking a detail-oriented and motivated Prior Authorization and Scheduling Representative to join our team in Tulsa, OK. This role is essential in coordinating patient services by managing prior authorizations and scheduling specialized studies. The ideal candidate will have strong analytical skills, attention to detail, and a solid understanding of healthcare authorizations, pre-certification, and scheduling processes.

Key Responsibilities

• Obtain Prior Authorizations: Secure necessary authorizations for special studies from various insurance carriers using carrier-specific tools and systems.
• Maintain Pre-Certification Knowledge: Keep current with each payer's pre-certification requirements, leveraging payer-specific websites and resources.
• Clinical Data Analysis: Evaluate and interpret clinical data in relation to authorization requests, cross-referencing medical terms, diagnoses, and CPT codes to ensure compliance with insurance requirements.
• Eligibility & Benefits Verification: Confirm eligibility and benefits for each special study request, ensuring accurate and compliant processing.
• Scheduling Coordination: Arrange appointments for authorized special studies, coordinating with patients and clinical teams to ensure optimal scheduling and resource utilization.
• Documentation: Accurately enter and maintain detailed notes in the practice management system regarding referrals, authorizations, special studies, and scheduling.

Qualifications

• Familiarity with medical terminology, CPT codes, healthcare authorization, and scheduling processes
• Strong analytical, organizational, and data management skills
• Proficiency in using payer-specific websites, tools, and scheduling software

TRINITY EMPLOYMENT SPECIALISTS IS AN EQUAL OPPORTUNITY EMPLOYER