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Prior Auth Assistant

Job Description

Prior Auth Assistant is responsible to obtain prior authorization for diagnostic exams and procedures when required by the patient's health insurance company.  The Assistant routinely communicates and collaborates with patients, insurance companies, other departments, and healthcare providers.  The assistant is also responsible and accountable for the schedule of procedures, pre-registration of patients and checking medical necessity of procedures as required.  Acts as a liaison between patients and hospital staff and works to resolve problems.

Monday - Friday day shift

Pay based on experience starting at $16.94

Responsibilities

Communicates with providers, hospital ancillary departments, and patients when tests and/or procedures are not approved by payer., Completes accurate and timely prior authorization for all applicable third party payers utilizing the internet, phone, and fax to ensure prior authorization is complete prior to date of service of test/procedure. , Completes accurate and timely retrospective prior authorization for all hospital admissions, Observation Services, Swingbed, ED visits for patients with Veteran’s Administration coverage, and “Stat” diagnostic orders that require prior authorization., Completes daily work timely and accurately to positively reflect quality improvement metrics., Completes insurance eligibility review to ensure insurance coverage is effective for the date test/procedure ordered., Completes preregistration for all patients with scheduled admissions, diagnostic tests, outpatient procedures, etc. in the Electronic Health Record system.  Responsible for collecting and verifying all patient demographics, physician, and insurance information.  , Reviews patient scheduler for various hospital departments each morning to identify patients that need prior authorization completed.  Completes review of patient scheduler throughout the day as patients are added for tests and/or procedures., Schedules patient diagnostic test(s) in a timely and accurate manner so not to delay patient care., Verifies that all necessary data elements needed for authorization (e.g., CPT codes, diagnosis and codes, medical records, etc.) are available.  

Requirements

High School (Required)

Compensation

Estimated Compensation Range

$16.94 - $26.26

Pay based on experience