Job Description:

Job Description:

• Reviewing and processing pre-authorization requests for medical procedures and treatments
• Verifying patient information and insurance coverage
• Collaborating with healthcare providers to gather necessary documentation
• Evaluating medical necessity and appropriateness of requested services
• Communicating with insurance companies and healthcare providers regarding authorization decisions
• Maintaining accurate and up-to-date records of pre-authorization requests and decisions

Responsibilities:

• Reviewing pre-authorization requests in a timely manner
• Ensuring compliance with insurance company policies and procedures
• Providing support and guidance to healthcare providers regarding pre-authorization requirements
• Making authorization decisions based on medical necessity and coverage guidelines
• Resolving any issues or concerns related to pre-authorization requests
• Coordinating with other members of the healthcare team to facilitate the authorization process

Skill Sets:

• Strong knowledge of medical terminology and procedures
• Excellent analytical and decision-making skills
• Effective communication and interpersonal skills
• Ability to work independently and as part of a team
• Attention to detail and accuracy in documentation
• Familiarity with insurance policies and procedures related to pre-authorization

Industry:

Insurance

Category:

Insurance Brokerage

Skills: