Pre Authorization Specialist - REMOTE ID - 1163

Industry: Private

Employment Type:- Full Time

Work Hours:-  8 Hours

Locations:- USA

Full Job Description:-

Pre Authorization Specialist - Remote

At Labcorp, you are part of a journey to accelerate life-changing healthcare breakthroughs and improve the delivery of care for all. You'll be inspired to discover more, develop new skills and pursue career-building opportunities as we help solve some of today's biggest health challenges around the world. Together, let's embrace possibilities and change lives!

The Pre Authorization Specialist position is responsible for supporting the Prior Authorization program at Labcorp by assisting with pre-billing tasks required by payers as a condition of payment for services provided. The Pre Authorization Specialist reviews medical policies, completes benefit investigations, initiates prior authorizations, provides cost estimates to patients, communicates outcomes with stakeholders, identifies trends, escalates issues, and performs other billing related tasks.

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RESPONSIBILITIES:

  • Be well-versed in all pre-authorization processes and policies to respond clearly to high volume billing tasks and inquiries
  • Maintain appropriate response time in various communication platforms (Example: phone calls, chats, emails, portal inquiries, etc)
  • Identify issues and suggest potential improvements
  • Collaborate with your team and develop best practices to ensure we are providing the best service and experience to all customers
  • Maintain an assigned schedule, and be flexible with daily schedules when business needs change
  • Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization
  • Work directly with various vendors to ensure successful submissions of prior authorizations
  • Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow ups, if necessary, to ensure timely approvals
  • Stay informed about insurance policies and guidelines, ensuring that all prior authorization requests align with the necessary criteria
  • Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases
  • Participate in projects that extend beyond your day to day to stretch you to think outside the box

REQUIREMENTS:

  • High school diploma or equivalent
  • Minimum 2+ years work experience in insurance claim pre-authorizations and explanation of medical benefits
  • High-speed internet (50mbps connectivity)
  • Private, quiet place to work remotely
  • Basic experience with Microsoft Office (Word, Excel, Outlook)
  • Effective customer relations and time management skills
  • Excellent verbal and written communication

Preferred qualifications:

  • Associate's degree or higher
  • 2 or more years of experience working in LCLS and/or LCBS
  • 1 or more years of clinical laboratory RCM experience

Pre Authorization Specialist - REMOTE ID - 1163

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