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Pre - Authorization Spec
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- The Pre-Authorization Specialist is responsible for identifying prior auth requirements by insurance/payer and processes and completes prior authorizations for scheduled and add on services.
- Determines if services are a covered benefit and documents pre-authorization information in Epic. Communicates with the ordering Provider's office if services were approved or denied to reduce denials and facilitates peer to peer reviews when needed.
- Determines if services are a covered benefit and documents pre-authorization information in Epic.
- Documents pre-authorization results completely and communicates to leadership, Providers and/or Nurses pre-authorization approvals or denials.
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