Prior Auth

Onsite Prior Authorization Specialist

Job Overview

Position requires utilization of clinical knowledge and excellent customer service skills to schedule appropriate procedures/surgeries per provider’s orders in the hospital, ambulatory
surgery center or in office places of service.

Location: Smyrna, GA
Hours: Normal Business Hours  
3 month contract to perm role

Responsibilities and Duties:

• Initiate and follow up on precertification for commercial payers either online or by phone as per payer protocol until a determination is obtained
• Obtain benefits and eligibility for professional fees from the insurance company and inform the patient appropriately
• Ensure all DME and MRI/X rays/CT scans are forwarded to the facility prior to the surgery date
• Consult with patient to schedule patient surgery and/or procedures while answering any questions as requested
• Collect any surgery deposits and assist the patient with setting up payment plans, educate patient on financial responsibility, and inform AR team patient information and payment plan.
• Enter the date of surgery and post operative visits in the EMR System
• Email a surgery packet to the patient including pre-op and surgery instructions, post op appointment, reminder of any balances to be collected prior to the surgery date, attach both the surgery handbook and facility information
• Consolidate surgery packet and forward to facility scheduled for procedure
• Coordinate COVID-19 test for non-vaccinated patients
• Coordinate surgery with other physicians and vendors
• Assisting in preop for medical clearance for scheduled procedure
• Assist as needed with clinic and patient workflow
• Document authorizations in EMR
• Coordinating direct admissions to nearby hospitals for CTCA and LBS patients
• Scheduling and coordinating all parties involved during patient surgery- outside vendors, first assists, anesthesia companies and neuro-monitoring company