Job Title: Prior Authorization Coordinator

Children’s Surgery Center

Overview:

We are seeking a detail-oriented and organized Prior Authorization Coordinator to join our team at Children’s Surgery Center. As a Prior Authorization Coordinator, you will be responsible for obtaining prior authorizations from insurance companies for dental surgeries and procedures. Your role is crucial in ensuring seamless administrative processes and facilitating timely patient care.

Responsibilities:

Obtain prior authorizations from insurance companies for dental surgeries and procedures.
Review patient medical records, treatment plans, and insurance coverage to determine authorization requirements.
Communicate effectively with patients, insurance companies, and healthcare providers to gather necessary information for authorization requests.
Submit authorization requests accurately and within specified timeframes to meet patient scheduling requirements.
Monitor the status of authorization requests and follow up with insurance companies as needed to expedite the approval process.
Collaborate with the billing department to ensure accurate billing and reimbursement for authorized procedures.
Maintain detailed records of authorization requests, approvals, denials, and appeals.
Stay informed about changes in insurance policies, billing procedures, and regulatory requirements related to prior authorizations.
Provide assistance and support to patients and healthcare providers regarding authorization-related inquiries and concerns.
Participate in training sessions and educational programs to enhance knowledge of insurance authorization processes and industry best practices.
Conduct cost estimates
Complete payments and check benefits
Obtain single case and letters of agreements

Requirements:

High school diploma or equivalent
Prior experience working in a healthcare setting, preferably in dental or medical office administration.
Familiarity with dental terminology, procedures, and coding systems.
Strong understanding of insurance verification, prior authorization, and claims processing procedures.
Excellent communication skills, both verbal and written, with the ability to interact professionally with patients, insurance companies, and healthcare providers.
Exceptional attention to detail and accuracy in data entry and record-keeping.
Proficiency in using electronic health records (EHR) systems and insurance verification software.
Ability to prioritize tasks effectively, manage multiple authorization requests simultaneously, and meet deadlines in a fast-paced environment.
Strong problem-solving skills and the ability to resolve authorization-related issues and challenges.
Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.
Willingness to adapt to changes in policies, procedures, and technology advancements in the healthcare industry.

Joining our team as a Prior Authorization Coordinator offers an exciting opportunity to play a vital role in ensuring patients receive timely access to dental care while navigating the complexities of insurance authorization processes. If you are dedicated, detail-oriented, and passionate about providing excellent patient service, we encourage you to apply.

Job Type: Full-time

Pay: $22.00 - $32.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: Remote

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