Prior Authorization Specialist
We are looking for an experienced Prior Authorization Specialist with a strong background in Pulmonology, Gastroenterology, and Internal Medicine. The ideal candidate will be responsible for obtaining timely prior authorizations, verifying insurance coverage, and ensuring accurate documentation to support smooth patient care delivery. Experience with NextGen software is highly preferred.
Key Responsibilities:
- Process and track prior authorization requests for medications, procedures, and treatments.
- Verify patient insurance coverage, eligibility, and benefits.
- Collaborate with physicians, nurses, and insurance providers to obtain necessary approvals.
- Document and update all authorizations and communications in NextGen EMR.
- Identify and resolve prior authorization delays or denials in a timely manner.
- Maintain compliance with HIPAA and payer-specific guidelines.