Prior Authorization Specialist

The Prior Authorization Specialist contacts insurance companies on behalf of patients to obtain prior authorizations for prescriptions, tests and procedures. Serves as a patient advocate and functions as a liaison between the patient and payor to address reimbursement questions and avoid insurance delays. Provides information to support the medical necessity of patient treatments and testing. Communicates with physicians and their team members to obtain necessary information as well as to inform them of any special requirements by particular insurance plans. Researches additional or alternative resources for non-covered services to prevent payment denials. Enters and scans information into Electronic Health Record as required.