Prior Authorization Representative

Job Summary We are seeking a detail-oriented Prior Authorization Specialist to join our healthcare team. The ideal candidate will be responsible for obtaining prior authorizations for medical procedures and services, ensuring compliance with insurance guidelines, and facilitating the approval process. Duties - Review patient medical records and treatment plans to determine the necessity of prior authorizations - Communicate with healthcare providers, insurance companies, and patients to gather necessary information for authorization requests - Submit authorization requests to insurance companies and follow up on pending requests - Maintain accurate records of authorization status and communicate updates to relevant parties - Stay current on insurance policies, guidelines, and procedures related to prior authorizations Qualifications - Experience in managed care or medical office setting preferred - Proficiency in medical coding, including ICD-9, ICD-10 codes - Knowledge of medical terminology and insurance verification processes - Strong attention to detail and organizational skills - Excellent communication and interpersonal abilities - Ability to work independently and as part of a team - Familiarity with dental office procedures is a plus If you are looking to utilize your skills in a dynamic healthcare environment and contribute to the efficient delivery of patient care, we encourage you to apply for the Prior Authorization Specialist position. Job Type: Full-time Pay: $16.00 - $19.03 per hour Benefits: 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Experience: Insurance verification: 3 years (Preferred) Medical billing: 3 years (Preferred) Ability to Commute: Chattanooga, TN 37403 (Required) Ability to Relocate: Chattanooga, TN 37403: Relocate before starting work (Required) Work Location: Hybrid remote in Chattanooga, TN 37403