Prior Authorization Specialist

Northside Hospital
Sandy Springs, GA
Posted 6 days ago
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Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

A prior authorization specialist is an individual who is highly skilled in ensuring that patients receive the medication that requires pre-authorizations from insurance carriers. These individuals receive prescriptions, address and rectify rejected claims and conduct necessary third party authorization requests.

REQUIRED: 1. High School Graduate or General Education Degree (GED). 2. CMA, or RMA or three (3) to seven (7) years related experience. 3. Understanding and experience with electronic medical records 4. Great communicator, with exceptional writing and verbal skills 5. Ability to project a professional image. 6. Strong knowledge of regulatory standards and compliance requirements, working knowledge of medical business office procedures and basic accounting. 7. Detailed understanding of ICD-9 and CPT. 8. Possess insight into reimbursement and claims procedures. PREFERRED: 1. Proficient in EMR 2. Two (2) to Four (4) years equivalent experience

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