Job Description

Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt, patients cost estimation calculation. Review and process pre-authorization requests for medical services, procedures, and treatments according to established guidelines and procedures Get prior authorization approval from insurance firms and nurse managers Appeal insurance companies after prior authorization refusals. Get prior authorization approval from insurance firms and nurse managers. Document account activity using correct medical and billing codes. At least 1 year of experience in obtaining prior authorization. Interact with the insurance rep to follow-up on appealed authorizations. Calling Insurances on claims resolutions and handling the denials for a closure