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Prior Authorization Specialist - Clinical/Office jobs in United States
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US Digestive Health · 2 weeks ago

Prior Authorization Specialist - Clinical/Office

US Digestive Health is seeking a Prior Authorization Specialist to effectively obtain insurance authorizations for patients prescribed medication. The role involves verifying insurance requirements, researching clinical information, and communicating authorizations to patients and physicians.
Health Care
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Responsibilities

Responsible for authorizations in multi-provider practice
Obtain patient insurance information and contact insurance carriers online or by phone to verify requirements
Research clinical information from medical record needed to obtain prior authorizations from insurance companies or patient assistance programs
Communicating authorizations to patients and physicians explaining approvals or denials for medication when needed
Field any phone calls and emails related to authorizations
Establish relationships with drug companies

Qualification

Medication AuthorizationInsurance Guidelines KnowledgeAllscripts EMRCustomer Service ExperienceComputer SkillsOrganizational SkillsProblem-Solving SkillsInterpersonal SkillsCommunication SkillsDecision-Making Ability

Required

High School Diploma or GED equivalent

Preferred

Minimum 3-5 years of experience in customer service preferred but not required
Prefer previous Medication Authorization responsibilities
Allscripts EMR program a plus

Company

US Digestive Health

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US Digestive Health is a network of gastroenterology practices focused on helping patients.

Funding

Current Stage
Late Stage

Leadership Team

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Mark Johnston
Partner Regional Gastroenterology Inc.
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Melissa DiGiacomo
Human Resources Business Partner
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Company data provided by crunchbase