UnityPoint Clinic
Prior Authorization Assistant
Monday-Friday 8:00AM-5:00PM
Full Time Benefits
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The Prior Authorization Assistant I supports patient care coordination by initiating and documenting insurance prior authorizations for patient services. This role emphasizes accurate data entry, adherence to payer and organizational standards, and professional communication with patients, internal teams, external places of service, and payers.
Prior Authorization/Obtaining Insurance
• Obtains insurance prior authorizations for office procedures, diagnostic testing, and imaging for patients.
• Obtains all pertinent clinic health information from provider, clinical staff and/or EMR to process authorizations, referrals, and pre-certifications.
• Verifies demographic information, including insurance, when scheduling and/or obtaining pre-certifications.
• Monitors outstanding authorization requests and initiates follow-up of outstanding authorizations in a timely manner.
• Completes timely and accurate documentation of authorization outcomes in the EHR.
• Maintains current knowledge of payer specific requirements of prior authorizations by attending virtual workshops, researching, reading newsletters.
• Follow department guidelines and payer protocols to initiate prior authorization processes.
• Coordinates authorization processes with scheduling staff so appointments can be made in timely manner.
• Communicate with clinics and referral teams to confirm completeness and accuracy of information.
• Meets department productivity and quality benchmarks.
• Ability to remain flexible and prioritize multiple work streams and process steps.
Customer Service
• Exhibits strong customer services skills and maintain professional communication standards through their work with payers, clinics, and patients.
• Adheres to department customer service standards.
• Collaborate with other departments to assist in obtaining prior authorizations in a cross functional manner.
• Readily identifies work that needs to be performed and completes it proactively.
• Monitors and responds professionally and timely to all inquiries and communications.
Education
High School diploma or equivalent.
Work Experience
• Minimum of 2 years previous experience in medical field.
• A working knowledge of insurance payers.
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