21 days old

Prior Authorization Specialist

Myriad Genetics Inc.
Salt Lake City, UT 84108
  • Job Code
    114195598
We are looking for a Prior Authorization Specialist/Reimbursement Specialist in a fast-paced, high-volume role. The Prior Authorization Specialist is responsible for submitting and following up on all Prior Authorization requests for a specific group of payers. Please see job responsibilities below for more detailed information on this position.

  • Verifies patient insurance coverage timely utilizing phone or online resources.
  • Submit prior authorizations to insurances in timely matter via payer specific portals.
  • Ensures all pertinent medical documentation is accurate and present prior to authorization submission.
  • Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval.
  • Communicates any authorization denials to the appropriate staff.
  • Handles any discrepancies, errors, or omissions of authorization denials and files appeals when necessary for overturn of adverse decision.
  • Works collaboratively with the entire billing department to meet company goals.
  • Participates in educational activities and attends regular staff and department meetings.
  • Exhibit and manage excellent turn-around time in order to ensure timely authorizations.
  • Consistently work in a positive and cooperative manner with fellow team members.
  • Demonstrate flexibility to perform duties wherever volume deems it necessary.
  • Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.
  • Document activities appropriately in process notes.
  • Participates in the Quality Assurance plan.
  • Complies with applicable CLIA and HIPAA regulations.
We are looking for a Prior Authorization Specialist/Reimbursement Specialist in a fast-paced, high-volume role. The Prior Authorization Specialist is responsible for submitting and following up on all Prior Authorization requests for a specific group of payers. Please see job responsibilities below for more detailed information on this position.<br /><br /> <ul> <li>Verifies patient insurance coverage timely utilizing phone or online resources.</li> <li>Submit prior authorizations to insurances in timely matter via payer specific portals.</li> <li>Ensures all pertinent medical documentation is accurate and present prior to authorization submission.</li> <li>Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval.</li> <li>Communicates any authorization denials to the appropriate staff.</li> <li>Handles any discrepancies, errors, or omissions of authorization denials and files appeals when necessary for overturn of adverse decision.</li> <li>Works collaboratively with the entire billing department to meet company goals.</li> <li>Participates in educational activities and attends regular staff and department meetings.</li> <li>Exhibit and manage excellent turn-around time in order to ensure timely authorizations.</li> <li>Consistently work in a positive and cooperative manner with fellow team members.</li> <li>Demonstrate flexibility to perform duties wherever volume deems it necessary.</li> <li>Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.</li> <li>Document activities appropriately in process notes.</li> <li>Participates in the Quality Assurance plan.</li> <li>Complies with applicable CLIA and HIPAA regulations.</li> </ul> <img src="https://analytics.click2apply.net/v/JB5obrcpAWbyIPJVfYXM2"> <br/><br/><br /><strong>Qualifications</strong><br /> <ul> <li>3-5 years of experience working in medical billing, health insurance or collections with demonstrated results.</li> <li>Insurance billing experience is preferred.</li> <li>Good problem solving and decision making skills.</li> <li>Excellent customer service and phone skills.</li> <li>Excellent time management, organizational, communication, multitasking and teamwork skills.</li> <li>Working knowledge of ICD-10, CPT and HCPCS coding (preferred but no required).</li> <li>Ability to successfully navigate between multiple systems throughout the course of the work day this includes but is not limited to billing software, written Standard Operating Procedures and payer portals.</li> </ul> <br /> <ul> <li></li> </ul> <p style="margin: 0px;">The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; talk; or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; and stoop; kneel; or crouch The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision and depth perception.</p><p>PI114195598</p>

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Posted: 2019-10-01 Expires: 2019-11-01

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Prior Authorization Specialist

Myriad Genetics Inc.
Salt Lake City, UT 84108

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