Prior Authorization Representative

Job Summary

A company is looking for a Prior Authorization Representative II.

Key Responsibilities

• Audit internal and external staff on workflows within Pre-Auth and Authorization Denials
• Provide training and presentations on authorization procedures to staff
• Conduct high-level analysis of reports and provide feedback to reduce denials

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 (preferred)
• ICD/CPT Coding Certification (preferred)
• Inpatient and day surgery prior authorizations experience (preferred)