Pre-Authorization Specialist

Location: Fully Remote (LatAm)

Schedule: CST

Salary: 1800 - 2000 USD/month

*This role is exclusively available to candidates from Latin America. Please submit your resume in English.*

We are looking for a proactive and dynamic Pre-Authorization Specialist to join an esteemed medical group practice specializing in Interventional Pain Management, located in Morris, IL. With a commitment to delivering exceptional patient care, we are seeking an individual who can provide remote administrative support to our medical team, enhancing operational efficiency and patient satisfaction.

Key Responsibilities:

• Verifying medical insurance coverage
• Effectively navigate and manage tasks through insurance portals
• Apply knowledge of ICD-10 and CPT codes for accurate medical billing and documentation
• Understanding and determining the rules of medical necessity
• Processing prior authorization requests
• Ensuring accurate data entry
• Evaluating individual requests for coverage authorizations
• Understanding criteria prior to submitting
• Obtaining pre-approval from insurance companies for patient medications and treatments
• Communicating with patients, insurers, and other appropriate parties
• Reviewing and interpreting medical documents

Requirements

• Bachelor's degree in healthcare administration, business administration, or related field preferred.
• Strong communication skills to effectively interact with patients, insurance companies, healthcare providers, and other relevant parties.
• Experience in verifying medical insurance coverage
• Ability to review and interpret medical documents
• Experience evaluating patient requests for coverage authorizations
• Strong understanding of ICD-10 and CPT coding systems for accurate medical billing and insurance claims
• Ability to efficiently use various insurance provider portals for submitting claims, reviewing coverage, and obtaining authorizations
• Excellent organizational skills, attention to detail, and ability to prioritize tasks effectively.

If you are enthusiastic about contributing to the provision of compassionate care and possess the necessary qualifications and skills, we invite you to apply for this role!