Prior Authorization Specialist

Are you a detail-oriented individual with a passion for helping others? Do you thrive in a fast-paced environment and enjoy solving complex problems? If so, we have an exciting opportunity for you as a Prior Authorization Specialist at Mercy.As a Prior Authorization Specialist, you will play a crucial role in ensuring that our patients receive the necessary medical treatments and services by obtaining pre-approval from insurance companies. Your attention to detail and strong communication skills will be essential in navigating the prior authorization process and advocating for our patients.To excel in this role, you must have a high school diploma or equivalent and at least one year of experience in a healthcare setting. Additionally, you must have a strong understanding of insurance plans, medical terminology, and prior authorization guidelines.If you are looking for a rewarding career in the healthcare industry and want to make a positive impact on the lives of others, then we encourage you to apply for our Prior Authorization Specialist position at Mercy. Join our compassionate team and be a part of our mission to provide exceptional care to our patients every day.

1. Obtain pre-authorization from insurance companies for necessary medical treatments and services for patients.
2. Navigate the prior authorization process and advocate for patients to ensure they receive the care they need.
3. Communicate with insurance companies, healthcare providers, and patients to gather and provide necessary information for prior authorization.
4. Review and verify patient insurance coverage and benefits to determine if prior authorization is required.
5. Ensure all necessary documentation and forms are completed accurately and in a timely manner.
6. Stay up-to-date on insurance plans, medical terminology, and prior authorization guidelines to effectively navigate the process.
7. Collaborate with healthcare providers and insurance companies to resolve any issues or denials in the prior authorization process.
8. Maintain patient confidentiality and adhere to HIPAA guidelines.
9. Provide excellent customer service to patients and healthcare providers, addressing any questions or concerns regarding prior authorization.
10. Accurately document all prior authorization activities and maintain detailed records for each patient.
11. Participate in training and education opportunities to improve knowledge and skills in the prior authorization process.
12. Collaborate with other team members to ensure smooth and efficient prior authorization processes.
13. Assist with other administrative tasks and duties as needed.

According to JobzMall, the average salary range for a Prior Authorization Specialist in Chesterfield, MO, USA is $39,000-$54,000 per year. However, this can vary depending on factors such as experience, education, and company size.

Mercy Health Foundation is a nonprofit organization dependent on the generosity of caring individuals to support Mercy’s mission of delivering compassionate care and exceptional service to the St. Louis community.