Initiate new prior authorization requests with providers. Find the correct forms based on patient insurance Verify patient insurance and Medicaid eligibility for service dates. Collaborate with prescribers and offices for accurate forms. Track request status and follow up with medical offices. Communicate authorization status to patients and providers. Manage appeals with medical offices. Answer internal inquiries about prior authorization requests. Verify insurance coverage and interact with in... more details
Job Summary/Company:
Sparks Group has partnered with a We're seeking a behavioral health care and social services agency located in Washington, DC. Together we are recruiting for a detail-oriented Prior Authorization- Insurance Verification Specialist to join the team.
Responsibilities:
Initiate new prior authorization requests with providers.
Find the correct forms based on patient insurance
Verify patient insurance and Medicaid eligibility for service dates.
Collaborate with prescribers and offices for accurate forms.
Track request status and follow up with medical offices.
Communicate authorization status to patients and providers.
Manage appeals with medical offices.
Answer internal inquiries about prior authorization requests.
Verify insurance coverage and interact with insurance companies
Explain insurance coverage and potential out-of-pocket costs to patients.
Maintain organized records of insurance verification and authorizations.
Stay updated on insurance policies and procedures for compliance.
Qualifications:
High school diploma or GED (Associate degree a plus).
Proficient in insurance verification processes.
Prior customer service or call center experience required.
Working knowledge of Microsoft Office Suite and experience with insurance portals (e.g., DC Medicaid EVS, AmeriHealth, Amerigroup, Medstar).
Excellent written and verbal communication skills.
Strong technical skills, analytical thinking, and attention to detail.
Passion for patient care and teamwork.
Ability to work flexible shifts (8:30 am - 5:00 pm).
Preferred Qualifications:
1+ year experience with pharmacy prior authorizations.
1-3 years of experience in patient registration or insurance verification.
Sparks Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, pregnancy, citizenship, family status, genetic information, disability, or protect veteran status.
Job Abstracts is an independent Job Search Engine. Job Abstracts is not an agent or representative and is not endorsed, sponsored or affiliated with any employer. Job Abstracts uses proprietary technology to keep the availability and accuracy of its job listings and their details. All trademarks, service marks, logos, domain names, and job descriptions are the property of their respective holder. Job Abstracts does not have its members apply for a job on the jobabstracts.com website. Additionally, Job Abstracts may provide a list of third-party job listings that may not be affiliated with any employer. Please make sure you understand and agree to the website's Terms & Conditions and Privacy Policies you are applying on as they may differ from ours and are not in our control.
We would like to take a second to Welcome You to Job Abstracts, the nation’s largest Pure Job Board. With over 3.1 million job listings from 15,000+ Companies & Organizations, we help job searchers find careers that match their interests. As an anonymous user, you have probably discovered how easy our system is to use. However, you have just scratched the surface of what we can offer.
We encourage you to Register so you can use our most powerful features: searching with multiple terms, setting up multiple locations, establishing favorite companies, and accessing your search history. If you find a job you like, you can apply directly for it, and then, keep notes on it. We will also keep a lookout for jobs that match your search terms and email you when we find something you may like.
You can register for free and the system is free to use. If you like our system so far, click on Register and unlock the power required by serious job searchers.
Any time you conduct a search, the system shows you job matches, ranked by their Relevance Score (RS).
The score is calculated by a proprietary algorithm that uses Intelligent Machine Learning.
The Relevance Score tells you how well the job opportunity matches your search term or terms.
When not logged in, the system is limited to one search term. Scores for single term matches are usually lower.
When you register, log in, and set up multiple terms prioritized by importance, the jobs found for you will receive a much higher Relevance Score.
