Prior Authorization Specialist

Job Description

Join Networks Connect LLC, a leading staffing agency, as we seek a skilled Prior Authorization Specialist for an exciting opportunity in the healthcare sector in the Silver Spring, MD area. This role is perfect for individuals with extensive experience in healthcare insurance processes, looking to leverage their expertise in a dynamic environment.

Responsibilities:

• Full Cycle Payor Navigation: Bring your 3+ years of healthcare experience into play, managing claims, billing, healthcare registration, and more.
• Patient Access Workflows: As part of the Patient Access team, you’ll be instrumental in navigating insurance prior authorization processes for various services, ensuring patient care continuity.
• Insurance Liaison: Work directly with physician offices, insurance carriers, and patients, ensuring complete insurance clearance prior to care provision.

Qualifications:

• Educational Background: High School Diploma/GED required.
• Experience: 3 years in healthcare, covering full cycle payor navigation, and 2 years in medical/insurance terminology. CPT and ICD coding experience also essential.
• Skills: Excellent communication, customer service, problem-solving, and computer skills.
• Software Proficiency: Experience with Cerner, Experian, or similar EMR systems preferred.
• Language Skills: Bilingual abilities are a plus.
• Training: Completion of all Patient Access training assessments.

Functional Accountabilities:

• Pre-Service Payor Clearance: Ensure pre-registration accuracy, verify insurance, and manage patient financial responsibilities efficiently.
• Patient Navigation and Notification: Act as a liaison for patients, managing insurance and financial aspects with clarity and empathy.

Organizational Accountabilities:

• Embrace a customer-focused approach.
• Foster teamwork and communication.
• Identify and implement process improvements.
• Manage resources efficiently and responsibly.
• Prioritize safety and accuracy in all tasks.

Benefits:

• Competitive salary ($50,000 – $60,000 per year).
• Full benefits package including 401(k), health, dental, life, and vision insurance.
• Paid time off.

Work Schedule:

• Monday to Friday, full-time on-site role.

If this Prior Authorization Specialist role aligns with your career aspirations, apply now at www.networks-connect.com and be part of a team that values making a difference in the healthcare sector!

Earnings

$50,000 - $60,000 salary

Category

Revenue Cycle