Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist.

Key Responsibilities:

• Acts as single point of contact for prior authorization and appeal processing communications to consumers, healthcare providers, field reimbursement representatives and other external stakeholders
• Supports Barostim prior authorizations, including entering and managing consumer information, verifying insurance coverage, calling insurance companies to obtain status of prior authorization requests, and working with consumers and sites to pursue authorization success
• Seeks continuous process improvement to increase success rates and reduce time to success, reads and interprets payer requirements relating to prior authorization

Required Qualifications:

• Previous prior authorization and reimbursement experience
• Knowledge of medical and claims processing terminology
• Comfortable working in a small start-up company with a dynamic environment and frequent changes in direction
• Knowledge of reimbursement compliance requirements and ability to maintain a high level of personal integrity to promote a compliant reimbursement environment
• Bachelor's degree or four (4) or more years of relevant experience in prior authorization and appeal requests (preferred)