LHH Recruitment Solutions is seeking a highly organized and detail-oriented Prior Authorization/ Pre-Certifications Specialist to join our clients growing healthcare team.
The Prior Authorization Specialist will be responsible for obtaining prior authorizations from insurance companies for medical procedures, medications, and treatments. This role requires strong communication skills to interact with healthcare providers, insurance companies, and patients to ensure timely approval of authorizations.
Responsibilities:
- Review patient medical records and treatment plans to determine the necessity of prior authorizations.
- Communicate with healthcare providers to gather necessary documentation for prior authorization requests.
- Complete prior authorization forms accurately and submit them to insurance companies within specified timeframes.
- Follow up with insurance companies to track the status of prior authorization requests and address any issues or discrepancies.
- Coordinate with healthcare providers and insurance companies to resolve prior authorization denials or appeals.
- Maintain accurate records of prior authorization requests, approvals, and denials.
Requirements:
- Bachelors degree in healthcare administration, nursing, or related field preferred.
- Prior experience working in a healthcare setting, preferably in a role involving prior authorizations & Pre- Certifications is required.
- Strong understanding of medical terminology and procedures.
- Excellent communication and interpersonal skills.
- Ability to multitask and prioritize tasks in a fast-paced environment.
- Proficiency in using electronic health record (EHR) systems and insurance verification software.
- Knowledge of insurance policies and procedures related to prior authorizations.
Pay Details: $20.00 to $25.00 per hour
Search managed by: Caitlin Keenan
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.
