Job Description

Job Description

Job Description

JobID: 50309

Prestige Staffing is hiring for a Prior Authorization Specialist to work in the office for several months until trained and offered a permanent role. Once trained and meeting production then they will be allowed to work remotely while maintaining productivity. Must have hospital prior authorization experience. This is a full time Mon- Friday normal work hour role. 

• Able to verify eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
• Able to determine which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites.
• Provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. 

• EPIC experience preferred
• 2+ years of prior authorization and pre certification experience preferably in a hospital setting
• Experience using all payer portals for commercial and government 
• Knowledge of how to keep claims from being denied due to great upfront pre-cert steps
• Able to pass drug test and criminal background

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