Prior Authorization Specialist Job at Safeguard Healthcare, San Juan Capistrano, CA

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  • Safeguard Healthcare
  • San Juan Capistrano, CA

Job Description

Job Description

Job Description

emp Assignment About 6 weeks

We are seeking a  Prior Authorization Specialist for a temporary role in San Juan Capistrano. This position involves a combination of secretarial tasks and medical administration duties, including working with insurance and prior authorizations.

Key Responsibilities:

  • Schedule Appointments : Coordinate patient visits.
  • Insurance Verification : Confirm insurance before appointments.
  • Patient Information : Input patient demographics and details.
  • Collect Payments : Process co-pays and outstanding balances.
  • Obtain Authorizations : Secure authorizations for visits (HMO, Workers' Comp).
  • Prior Authorization : Execute the principles of prior authorization to ensure patients receive appropriate care at the right time and in the right setting.
  • Problem Solving : Address complex prior authorization questions and issues.
  • Eligibility & Benefits Check : Verify coverage for services like DME (Durable Medical Equipment) and home health before passing on requests for approval.
  • Compliance : Ensure all authorizations meet required turnaround times and maintain compliance in all steps of the prior authorization process.
  • Resource Management : Use supplies and equipment responsibly.
  • HIPAA Compliance : Protect patient confidentiality at all times.
  • Administrative Tasks :
  • Answer phone calls.
  • Sort and distribute mail and faxes.
  • Manage medical records.
  • Referrals :
  • Coordinate patient referrals to specialists or diagnostic services.
  • Obtain authorizations for referrals.
  • Communicate with patients, providers, and insurance companies regarding the status of referrals.
  • Maintain accurate referral records in compliance with HIPAA.

Required Skills & Qualifications:

  • Medical Office Experience : Prior experience in scheduling, phone operations, and working in a medical setting.
  • Communication : Strong written and verbal communication skills.
  • Technical Skills : Intermediate proficiency in math and computer skills. Familiarity with medical software.
  • Multitasking : Ability to prioritize and manage multiple tasks in a fast-paced, high-stress environment.
  • Interpersonal Skills : Friendly, outgoing, and able to interact professionally with staff and patients at all levels.
  • Confidentiality : Knowledge of HIPAA regulations and ability to maintain patient privacy.

This position requires someone who can handle changing priorities and solve complex prior authorization issues while maintaining a positive and professional attitude.

If you are organized, detail-oriented, and enjoy working in a healthcare setting, apply today!

Job Tags

Temporary work,

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