Position Overview:

Serves as a patient's advocate during the Prior Authorization approval process.

Status: Full Time, Non-Exempt

Reports to: Prior Authorization Team Lead

Positions reporting to this position: None

Department: Prior Authorization

Location: Dallas, TX

 

Education / Licensing Requirements:

High School Diploma or GED required. 

 

Experience Requirements:

1-2 years’ experience in a high volume prior authorization environment preferred.

 

Essential Skills/Experience

• Organizational skills
• Proven time management skills
• Team player
• Accurate data entry skills
• Excellent attention to detail
• Proven ability to prioritize and multi-task

Characteristics

• Sense of urgency

• Organized, detail-oriented; catches errors early

• Ethical; respects confidentiality

Responsibilities

• Communicates with insurance carriers and the physician in order to complete patient prior authorization.
• Analyze all patient documents to anticipate any issues that may occur with the prior authorization approval.
• Completes all necessary insurance documents, transmitting them for approval.
• Communicates with the physician’s office throughout the PA process.
• Responsible for reporting all customer complaints.
• Responsible for communicating with the physician’s office if a PA has been not been approved. Based on physician request, appeal may be required.
• Responsible for LMN reviews
• Knowledgeable regarding Senderra’s community values and demonstrates them daily.
• Participates in staff meetings, conference calls, and other meetings, as needed.
• Performs other incidental and related duties as required

Working Conditions

• Fast-paced environment.
• Requires normal vision (corrected) both close and distant.
• Requires normal hearing levels (corrected).
• Requires working at a desk to use a phone and computer for extended periods of time. Requires sitting, bending.
• Uses office equipment and machinery effectively.
• Requires normal finger dexterity for keyboarding.
• Works effectively with frequent interruptions.
• Lifting requirements of 15 pounds occasionally.
• Minimal travel <10%.