Prior Authorization Specialist Job at Twin Cities Pain Clinic, Edina, MN

N1JvSkRuaE5Ga0J4bVY5bm5BcnhybWZtWUE9PQ==
  • Twin Cities Pain Clinic
  • Edina, MN

Job Description

Position Title: Prior Authorization Specialist

Supervisor: Prior Authorization Manager

FLSA Status: Non-Exempt

Mission:

To provide our patients and community the most innovative and breakthrough treatment options to improve overall health and wellness.

Values:

Innovation

Integrity

Patient Experience

Teamwork

Job Summary:

  • Manages and processes Prior Authorizations including, but not limited to, Medicare, Commercial, Medicaid, and Worker’s Compensation for injections, procedures, and other prior authorization needs.
  • Identifies insurance coverage and coordinates with patients on their pre-procedure requirements.
  • Expert on insurance prior authorization requirements, policies, and guidelines.
  • Effectively communicates with insurance companies, physicians’ offices, outside vendors, and patients.
  • Resource for providers in determining patient authorization needs.
  • Manages and processes authorization denials and appeals.
  • Processes prior authorization paperwork.
  • Facilitates prior authorization projects and tracking metrics as required.
  • Cross-trains on other duties as required.

Supervisory Responsibility:  

  • This position has no supervisory responsibilities.

Qualifications:

  • High School Diploma or GED required.
  • Associate’s or Bachelor’s degree preferred.
  • Minimum of 1-year of prior authorization experience required in healthcare environment.
  • Medical terminology preferred (CPT/HCPCS, ICD-10 Codes, Procedures, etc.)
  • NextGen experience preferred.

Skills & Abilities:

  • Detailed oriented with ability to manage multiple priorities and work in a highly active environment.
  • Strong verbal and written communication skills.
  • Strong knowledge of insurance and eligibility.
  • Ability to problem solve.
  • Proficient computer and business skills.
  • Self-directed, reliable, consistent.
  • Ability to multi-task.
  • Ability to work independently and with a team.
  • Ability to be a professional representative of the company.
  • Ability to follow directives as presented by your supervisor.
  • Ability to follow company policies and procedures.
  • Ability to abide by all HIPAA privacy laws.

Work Environment:

While performing the duties of this job, the employee regularly works in an office setting. This is not a remote position.

Physical Demands

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 occasionally required to walk; sit; use hands to grasp or handle objects, tools, or controls; reach with hands and arms; stoop, kneel, or crouch; talk or hear. The employee must be able to sit for 90% of the day and occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Compensation & Work Schedule:

  • Full-time: 40 hours/week.
  • Non-Exempt.
  • Day Shift: Monday-Friday 8:00AM-4:30PM.
  • No evenings or weekends.
  • A competitive benefits package including health, life and dental insurance, 401K, PTO time, paid holidays and HSA plan is offered.

Job Tags

Holiday work, Full time, Weekend work, Day shift, Afternoon shift, Monday to Friday,

Similar Jobs

Homestead & Co

Licensed Transaction Coordinator Job at Homestead & Co

Our real estate office is seeking a transaction coordinator who can effectively assist our valued home buyers and sellers from contract to close. Youll work...  ...service and a great customer experience Real estate license preferred High school diploma required;... 

77 Consultants

Registered Nurse - Case Manager Job at 77 Consultants

 ...: Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets...  ...(CM) standards of care. Provide nursing expertise about the CM process,...  ...using inpatient, outpatient, onsite and telephonic CM Develop and implement tools to support... 

Crystal Clear Building Services

School Cleaner - Part-Time - Evening Job at Crystal Clear Building Services

 ...industrial, commercial, and construction customers throughout Northeast Ohio for the past 28 years. Job Description Location: School Cleaning in Cleveland, OH 44104 Days: Monday through Friday Time: 5:00 p.m. to 8:30 p.m. Pay Rate: $13.50 per hour... 

State of Ohio Jobs

Program administrator Job at State of Ohio Jobs

 ...The Industrial Commission is committed to providing access and inclusion and reasonable accommodation in its services, activities,...  ...employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. To request a reasonable... 

National Testing Network

Police Officer-City of St. Mary's Job at National Testing Network

 ...) Top Wage: $30.21/hour Employees with an associate degree or higher in law enforcement, police science, criminology, or criminal justice receive an additional $1.05/hour after completing the training period. Benefits Information: Health and life insurance...