Prior Authorization Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $19 - $21 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Point Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare Insurance • Healthcare • Wellness

Point Health is a healthcare company that specializes in providing treatment solutions for chronic pain management. They collaborate with top-rated physicians and clinics to offer next-day appointments, making it easier for patients to access care. By leveraging a multidisciplinary approach, Point Health aims to provide effective pain management strategies while ensuring a seamless experience for patients, including the option for insurance evaluations and minimal wait times.

📋 Description

• Manage the entire authorization process for interventional pain management procedures • Monitor advanced procedure trackers for each practice to identify authorization opportunities • Collect all required documentation for prior authorizations • Review medical necessity guidelines for procedures by Paycor • Accurately and promptly submit prior and retro authorization requests to payors • Document account activity, updating patient and claim information to ensure efficient claim processing • Identify trends or issues that delay authorization or claims processing • Communicate with practices, vendors, insurance companies, patients, and management to secure necessary approvals • Provide the highest level of customer service to internal teams • Serve as a backup to the Contact Center Team during peak scheduling call times • Perform other related duties as assigned to support smooth operations and patient care continuity

🎯 Requirements

• High School Diploma or GED (required) • Minimum of 1 year of prior authorization and clinical setting experience (required) • Experience working within Pain Management required • Proficient in Microsoft Office Suite • Strong analytical and problem-solving abilities • Excellent organizational skills and attention to detail • Knowledge of HIPAA privacy and security requirements • Basic understanding of medical terminology • Familiarity with payor portals and medical policy navigation • Must be able to sit for extended periods, communicate clearly, perform computer-based tasks, occasionally lift up to 25 lbs, and maintain close vision, depth perception, and focus adjustment.

🏖️ Benefits

• Health, Dental & Vision Insurance • Accident and Life/AD&D Insurance • Short & Long-Term Disability • Emergency Travel Assistance Program • ID-theft Protection Services • LifeMart Employee Discount Program • Health Savings Account (HSA) • Health Management Tools • Paid Time Off (PTO) • Company Paid Holidays • Paternal Leave • 401(k) Retirement Plan • Remote Stipend • Travel Reimbursement • Continuing Education Reimbursement • Bonusly (employee recognition platform) • DailyPay (on-demand pay access)