Prior Authorization Representative

Job Summary

A company is looking for a Prior Authorizations and Referral Management Representative.

Key Responsibilities

• Coordinate prior authorization and referral processes for patients requiring services and testing
• Validate patient health plan coverage and communicate necessary information to health plans
• Facilitate scheduling of patients with various departments and maintain accurate records of authorizations and referrals

Required Qualifications, Training, and Education

• High School diploma or GED required; college-level coursework preferred
• Minimum of one year experience in a hospital, clinic, or medical insurance billing office
• Basic understanding of medical coding
• Ability to use electronic medical records systems and MS Office applications
• Must be able to wear appropriate Personal Protective Equipment (PPE) as required