Prior Authorization Submit Specialist
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
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Sense of urgency
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Organized, detail-oriented; catches errors early
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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%.