Prior Authorization Specialist

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Requirements:

• High School Diploma.
• Previous prior authorization and reimbursement experience.
• Knowledge of medical and claims processing terminology.
• Excellent written/verbal communication skills with the ability to provide clear instructions.
• Must be able to work independently with a high attention to detail and processes.
• Strong critical thinking and problem-solving skills.
• Comfortable working in a small start-up company with a dynamic environment and frequent changes in direction.
• Knowledge of reimbursement compliance requirements and ability to maintain a high level of personal integrity.

Responsibilities:

• Managing Barostim prior authorizations and accurately maintaining consumer information in the database.
• Assisting with consumer intake and verifying insurance coverage.
• Communicating with insurance companies to track the status of authorization requests.
• Collaborating with consumers and sites to achieve successful authorizations.
• Continuously refining workflows to boost success rates and accelerate authorization timelines.
• Partnering with the manager and HCA team to execute effective action plans and objectives.
• Streamlining the onboarding of new sites and providing timely case updates to sales teams.
• Interpreting and responding to payer guidelines to ensure compliance and maximize outcomes.