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Prior Authorization Specialist (Remote)

Addison, TX
About us:
Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates.   We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent.

The job duties of a health insurance prior authorization specialist may include:

1. Reviewing medical records and treatment plans to determine if prior authorization is required for specific procedures, treatments, or medications.
2. Verifying insurance coverage and eligibility for patients.
3. Gathering necessary information from healthcare providers, such as medical records, test results, and treatment plans, to support the prior authorization request.
4. Completing and submitting prior authorization requests to insurance companies, ensuring all required documentation is included.
5. Following up with insurance companies to track the status of prior authorization requests and resolve any issues or delays.
6. Communicating with healthcare providers to obtain additional information or clarification on prior authorization requests.
7. Educating healthcare providers and patients on insurance coverage and prior authorization requirements.
8. Assisting with insurance claims processing, including reviewing claims for accuracy and completeness.
9. Maintaining accurate and up-to-date records of prior authorization requests, approvals, and denials.
10. Staying updated on changes in insurance policies, prior authorization guidelines, and industry regulations.
11. Collaborating with other members of the healthcare team, such as nurses, doctors, and billing specialists, to ensure timely and accurate prior authorizations.
12. Providing excellent customer service to patients, insurance companies, and healthcare providers, addressing any inquiries or concerns related to prior authorizations.

2 years working with Prior Authorizations 
Prior Authorization experience for Medical - Pharmacy will not be considered 
Managed Care experience 
High School Diploma 


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