Eligibility and Prior Authorization Specialist

My obgyne is seeking a detail-oriented and knowledgeable Eligibility and Prior Authorization Specialist to join our practice.

The ideal candidate will be responsible for verifying patient benefits and ensuring compliance with insurance guidelines.

Responsibilities :

• Verify patient insurance benefits and coverage for OBGYN services in clinic.
• Obtain prior authorizations and pre-certifications for treatments as required by insurance providers.
• Communicate with insurance companies, patients, and healthcare providers to resolve any authorization or benefits-related issues.
• Maintain accurate records of authorizations, approvals, and denials in the electronic health record (EHR) system.
• Educate patients about their insurance benefits, coverage limitations, and out-of-pocket costs.
• Work closely with the billing department to address claim denials related to authorization issues.
• Stay up to date with insurance policies, coding changes, and payer requirements.
• Provide administrative support to the practice as needed, including scheduling and coordinating patient services.

Requirements :

Benefits :