Prior Authorization Representative

Konsus, Inc. (Superside); United States; Remote; USD 45,000 - 65,000; Full time

Job summary

A leading company is seeking a Prior Authorization Representative II to join their remote team. The role involves contacting insurance companies for patient eligibility and authorizations, maintaining documentation, and following up on requests. Candidates with three years of healthcare financial experience and coding certification are preferred.

Qualifications

• Three years of experience in a health care financial setting.
• Six months of experience as a Prior Authorization Rep I.
• Previous experience with insurance and prior authorizations preferred.

Responsibilities

• Contact insurance companies for patient eligibility and benefits.
• Follow up on delayed or denied authorization requests.
• Maintain documentation and liaison between payers and clinic staff.

Skills

Communication

Negotiation

Documentation

Education

ICD/CPT Coding Certification

Job description

A company is looking for a Prior Authorization Representative II to join their remote team.

Key Responsibilities

• Contact insurance companies for patient eligibility, benefits, and authorization
• Follow up on delayed or denied authorization requests and facilitate medical determinations
• Maintain documentation of authorization history and serve as a liaison between payers and clinic staff

Required Qualifications

• Three years of experience in a health care financial setting, or equivalent
• Six months of experience as a Prior Authorization Rep I or equivalent prior-authorization experience
• Previous experience with insurance and prior authorizations is preferred
• ICD/CPT Coding Certification is preferred
• Experience with inpatient and day surgery prior authorizations is preferred