Surgery Prior Authorization Specialist: Streamline Care

Hartford HealthCare; Trumbull (CT); On-site; USD 42,000 - 65,000; Full time

Job summary

Hartford HealthCare is seeking a Prior Authorization Specialist in Trumbull to obtain insurance authorizations for in-office procedures and surgical services. Under the direction of the Manager, you will maintain resources and EPIC documentation, and access insurance portals as needed.

You will monitor authorizations, contact insurers, document details, inform providers of denials, collaborate with pharmacy on plan drug choices, and support billing and front desk tasks as required.

Qualifications

• High School Diploma preferred.
• Experience with insurances and prior authorizations.
• Experience communicating with physicians, staff, patients and insurers.

Responsibilities

• Monitor and verify insurance information and pre-authorization requirements for procedures.
• Contact insurers to obtain prior authorization via phone or portals.
• Document authorization details in EPIC.
• Notify providers of denials and support peer-to-peer reviews.
• Collaborate with pharmacy on preferred drugs for insurance plans.
• Maintain log of missed authorizations and assist with appeals.
• Coordinate with hospital departments on billing and policies related to prior authorizations.
• Assist in front desk duties when time allows.
• Manage referral work queue and scheduling support.

Skills

Communication

Customer service

Organization

Telephone skills

Computer skills

Education

High School Diploma

Tools

EPIC

Job description

Hartford HealthCare is seeking a Prior Authorization Specialist in Trumbull to obtain insurance authorizations for in-office procedures and surgical services. Under the direction of the Manager, you will maintain resources and EPIC documentation, and access insurance portals as needed.

You will monitor authorizations, contact insurers, document details, inform providers of denials, collaborate with pharmacy on plan drug choices, and support billing and front desk tasks as required.