MyOBGYN Centennial Hills Eligibility and Prior Authorization Specialist

Job Title: Eligibility and Prior Authorization SpecialistLocation: Las Vegas, NVJob Type: Full-TimeAt Hera , we believe women's healthcare deserves higher standards where value is placed on the quality of care provided, and the best patient outcomes are achieved. We believe by focusing on data-driven and sustainable ways of optimizing outcomes within a culture that promotes evidence, collaboration and leadership we can and will achieve better healthcare for women and babies.My OBGYN , a Hera affiliate, is a medical practice in Las Vegas dedicated to providing exceptional patient care. We are committed to delivering high-quality healthcare services in a compassionate and efficient manner. As part of our team, you'll have the opportunity to contribute to improving the health and well-being of our community.Position Overview:My OBGYN is seeking a detail-oriented and knowledgeable Eligibility and Prior Authorization Specialist to join our practice. The ideal candidate will be responsible for verifying patient benefits, obtaining prior authorizations for procedures and medications, and ensuring compliance with insurance guidelines.Responsibilities: Verify patient insurance benefits and coverage for OBGYN services, including office visits, diagnostic tests, and surgical procedures.Obtain prior authorizations and pre-certifications for procedures, treatments, and medications as required by insurance providers.Communicate with insurance companies, patients, and healthcare providers to resolve any authorization or benefits-related issues.Maintain accurate records of authorizations, approvals, and denials in the electronic health record (EHR) system.Educate patients about their insurance benefits, coverage limitations, and out-of-pocket costs.Work closely with the billing department to address claim denials related to authorization issues.Stay up to date with insurance policies, coding changes, and payer requirements.Provide administrative support to the practice as needed, including scheduling and coordinating patient services.Requirements: Minimum of 6 months' of experience in completing prior authorization for a medical facility; OBGYN or women's health setting PREFERREDMedical Assistance experience PREFERREDStrong understanding of insurance policies, prior authorization processes, and medical billingProficiency in electronic health records (EHR) preferably AthenaOneExcellent communication and customer service skillsStrong attention to detail and ability to work efficiently in a fast-paced environmentBenefits: Medical insuranceDental insuranceVision insurance401k with company matchCompany-paid Life insurancePaid Time Off/Paid holidaysPowered by JazzHR