Pre-Authorization Specialist Job – Rome, GA

Position Summary: The person in this position will be responsible for monitoring incoming patient orders and gathers information needed to complete pre-certifications and pre-authorization for specialty biologic medications, coordinating shipments with specialty pharmacies, scheduling patient appointments all under the direction of Biologic Program Manager.

Licensure/Certification/Registration: None

Education/Qualifications:

High school diploma or general education degree (GED) is required

• Three to five years of experience, preferably in a healthcare setting
• Familiar with medical terminology
• Experience with prior authorization submission through cover my meds preferred
• Insurance verification experience preferred
• Excellent communication skills, both written and oral
• Proficient computer skills including word processing, and data entry, excel
• Must have ability to communicate professionally and effectively with management, co-workers, hub personnel, as well as vendors and other third parties

Job Responsibilities:

• Communicate professionally and effectively with management, co-workers, hub personnel, as well as vendors and other third parties

• Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements
• Request, track and obtain pre-authorization from insurance carriers prior to services being performed
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations
• Communicate any insurance changes or trends among team
• Maintains a level of productivity suitable for the department
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format
• Other duties as assigned

Job Type: Full-time