Prior Authorization Nurse

We are seeking a detail-oriented Prior Authorization Specialist to join our team. The ideal candidate will have a strong understanding of medical terminology, insurance verification processes, and prior authorization procedures.

Review and process prior authorization requests for medical procedures, services, and medications Verify insurance coverage and eligibility for patients Communicate with healthcare providers, insurance companies, and patients to gather necessary information Ensure compliance with HIPAA regulations and maintain patient confidentiality Utilize ICD-10 and ICD-9 coding systems to accurately document medical procedures Collaborate with managed care organizations to obtain necessary authorizations