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Prior Authorization Specialist - Hybrid
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- going beyond basic care to health programs integrated across the entire continuum of care.
- The Prior Authorization Specialist serves the patients, staff, and clinicians of Oregon Medical Group by requesting prior authorization approvals for planned, scheduled, or rendered procedures, services, or medications.
- The Prior Authorization Specialist is responsible for the timely submission of all documentation, forms, or electronic requests in a timely fashion to not impede our community's access to care.
- Obtains insurance prior authorization for patient prescriptions, treatments, services, or procedures and re-authorization for additional units including performing any retro-authorization requests as allowed by payers; appeal prior authorization denials and help facilitate peer-to-peer reviews as needed.
- Monitor pre-auth denials for trends and provider documentation issues, and escalate to Lead or Supervisor as appropriate
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