Pre-Authorization Specialist – Insurance Portal Experience

🔥 7 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $18 - $29 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Carle Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

⚕️ Healthcare Insurance

🏥 Healthcare

📚 Education

Healthcare Insurance • Healthcare • Education

Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.

📋 Description

• Identify prior authorization requirements by insurance/payer • Process and complete prior authorizations for scheduled and add-on services • Determine whether services are covered benefits • Document pre-authorization information and results in Epic • Communicate approvals or denials to ordering provider offices, leadership, providers, and nurses • Process pre-authorizations in a time-sensitive manner to reduce denials • Collaborate with physicians and nurses to secure clinical information for submissions • Facilitate peer-to-peer reviews when needed • Identify challenges, trends, and patterns and work with management to resolve them • Perform other duties as assigned

🎯 Requirements

• Highschool Diploma or GED • Direct insurance portal experience • Proficiency utilizing third party payer/insurance portals for pre-authorization submissions • Detailed knowledge of insurance providers, their portals, and authorization approval expectations • Basic English reading skills • Basic English writing skills • Basic English oral skills • Ability to respond appropriately to customers and co-workers • Ability to interact with a wide variety of people • Ability to maintain confidential information • Ability to communicate only facts to recipients or decline to reveal information • Ability to project a professional, friendly, helpful demeanor • Basic computer knowledge, including word processing, spreadsheets, email applications, and web browsers • Comfortable with Windows OS and learning new applications • Ability to work Monday-Friday, 8:00 a.m.-5:00 p.m. Central

🏖️ Benefits

• Comprehensive benefits package • Equal Opportunity Employer • E-Verify participation