Prior Authorizations Rep (31182)

Description
Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals throughout Arizona.

• Review EMR chart messaging and review schedules daily for upcoming surgical & in-office procedures

• Review chart documentations to ensure patient meets medical policy guidelines

• Prioritize authorization requests according to urgency

• Obtain authorization via payer website or by phone and follow up regularly on pending cases

• Verify coverage and benefits and calculate any out-of-pocket portions due

• Contact patients to review any out-of-pocket portions due prior to surgery

Requirements

• Minimum 1 year prior authorization experience

• Understanding of payer medical policy guidelines to manage authorizations effectively

• Proficient use of CPT and ICD10 codes

• Detail-oriented and above-average organizational skills

• Plans and prioritizes to meet deadlines

• Ability to multitask and remain focused while managing a high volume, time-sensitive workload

• Urology experience helpful

Requirements
Physical Requirements:
Requires sitting for extended periods. Some bending, stretching, and stooping required. Manual dexterity enough to use a keyboard and calculator. Normal range of hearing and vision and verbal communication is required. Use of a telephone is required.

Performance Requirements:
Knowledge of billing and insurance practices and procedures as well as regulations including Medicare, Medicaid, and third-party insurance companies including managed care contracts. Knowledge of current ICD-10 and CPT codes is required. Strong communication skills are required.