• Prior Auth Specialist - Geneva Primary

    Finger Lakes Health (Geneva, NY)


    #1478

     

    Geneva, NY, USA

     

    Pay Range

     

    20.71-24.04

     

    Pay Range

     

    20.71-24.04

    Job Description

    Responsibility

    Summary:

    Under the direction and supervision of the Practice Manager, obtains approval from insurance companies (including all commercial plans, state plans, Workers Comp, and VA) for medical services, procedures, or medications by verifying coverage, collecting clinical and demographic information, and documenting all communication. Key responsibilities include managing the submission and tracking of authorization requests and denials, coordinating and scheduling patient appointments and procedures, acting as a liaison between providers and payers, and ensuring timely patient care and financial coverage.

    Essential Job Functions:

    (Maximum of the first 5 will be included in the performance appraisal)

     

    Managing the submission and tracking of authorization requests for medical services, procedures, and medications for all insurance plans, including; commercial, state plans, Workers Comp, and VA.

     

    Collects and accurately document demographics, clinical, and insurance details. Confirm patient eligibility and benefits for proposed treatment

     

    Serve as a central point of contact between patients, healthcare providers, and insurance companies to facilitate the approval process.

     

    Maintains an extensive understanding of insurance plans and treatment criteria for services.

     

    Performs other duties as assigned.