PRIOR AUTHORIZATION SPECIALIST

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    "description": "<p>Position Title: Prior Authorization Specialist </p>\n<p>Department: Business Office </p>\n<p>Supervisor’s Title: HIM/Business Office Manager </p>\n<p>IHA# Position Summary: </p>\n<p>The Prior Authorization Specialist is responsible for obtaining pre-certifications and pre-authorizations for procedures performed at Valor Health. Developing and implementing prior authorization workflow, policies, and procedures. Principal Functions and Responsibilities: </p>\n<ol>\n\t<li>Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements. </li>\n\t<li>Request, follow up and secure prior authorizations prior to services being performed at Valor Health. </li>\n\t<li>Prioritize incoming authorization requests according to urgency. </li>\n\t<li>Collaborate with other departments to assist in obtaining prior authorizations in a cross-functional manner. </li>\n\t<li>When necessary, work with billing specialist to obtain a retro authorization. </li>\n\t<li>Assist with medical necessity documentation and submit medical records to expedite approvals and ensure that appropriate follow up is performed. </li>\n\t<li>Review accuracy and completeness of information requested and ensure that all supporting documents are present. </li>\n\t<li>Responsible for reviewing all encounters and mailing out Consolidated Summary of </li>\n\t<li>Attends and participates in meetings as requested. </li>\n\t<li>Performs other duties as assigned. </li>\n</ol>",
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