Prior Authorization Representative

Job Summary

A company is looking for a Remote Customer Service Rep II (Prior Authorization Representative).

Key Responsibilities

• Verify patient insurance coverage and communicate issues to management
• Initiate and coordinate prior authorization requests and required paperwork
• Follow up on authorization status and assist with appeals for denials

Required Qualifications

• Basic knowledge of payer payment processes and prior authorization requirements
• Familiarity with ICD9/10 and CPT codes, specifically Medtronic therapy codes
• Advanced skills in Microsoft Excel and ability to learn CRM software
• Organizational skills to manage multiple inquiries simultaneously
• Experience in customer service with various stakeholders