Prior Authorization Specialist

Assist Point Inc; Bedford (TX); On-site; USD 40,000 - 65,000; Full time

Job summary

Assist Point Inc in Bedford, TX seeks a detail-oriented Prior Authorization Specialist to join our healthcare team. You will manage and process prior authorization requests, working with providers and insurers to obtain timely approvals.

The role emphasizes accuracy, regulatory compliance, and clear communication with patients and staff. Experience with EMR and medical billing is valued, with opportunities for growth and professional development.

Qualifications

• High school diploma or equivalent is required; college degree is a plus.
• Experience in prior authorization, medical billing, or healthcare administration is a plus.
• Strong knowledge of insurance plans and healthcare regulations is essential.
• Proficiency with EMR systems and Microsoft Office Suite is required.

Responsibilities

• Review and process prior authorization requests submitted by healthcare providers.
• Communicate with insurance companies to obtain necessary approvals for medical procedures, treatments, and medications.
• Verify patient insurance coverage and eligibility.
• Maintain accurate and up-to-date records of all prior authorization activities.
• Collaborate with healthcare providers, patients, and insurance representatives to resolve any issues or denials.
• Ensure compliance with all regulatory and organizational policies related to prior authorizations.
• Provide timely updates to patients and providers regarding the status of their authorization requests.

Skills

Insurance knowledge

Communication

Independent work

EMR / MS Office

Education

High school diploma or equivalent

Associate's or Bachelor's degree preferred

Job description

We are seeking a detail-oriented and organized Prior Authorization Specialist to join our team. The ideal candidate will be responsible for managing and processing prior authorization requests to ensure timely approval of medical services and medications for our patients.

Responsibilities

• Review and process prior authorization requests submitted by healthcare providers.
• Communicate with insurance companies to obtain necessary approvals for medical procedures, treatments, and medications.
• Verify patient insurance coverage and eligibility.
• Maintain accurate and up-to-date records of all prior authorization activities.
• Collaborate with healthcare providers, patients, and insurance representatives to resolve any issues or denials.
• Ensure compliance with all regulatory and organizational policies related to prior authorizations.
• Provide timely updates to patients and providers regarding the status of their authorization requests.

Qualifications

• High school diploma or equivalent; Associate's or Bachelor's degree preferred.
• Previous experience in prior authorization, medical billing, or healthcare administration is a plus.
• Strong knowledge of insurance plans, medical terminology, and healthcare regulations.
• Excellent communication and interpersonal skills.
• Ability to work independently and manage multiple tasks efficiently.
• Proficient in using electronic medical records (EMR) systems and Microsoft Office Suite.