Job description
Overview:
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares. Responsibilities:
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
Education
A.
High School diploma or GED from an accredited institution
B.
Experience
A.
2 years of medical office experience either in a physician office or hospital setting, health plan, ACO, or other managed care setting.
Experience navigating payor web portals.
B.
Knowledge of CPT & ICD 10 Coding methodologies.
Prior experience with precertification and/or utilization management.
Licenses
A.
B.
Special Skills
A.
Working knowledge of medical terminology and HMO/ PPO authorization processes.
Excellent communication skills
Alpha/numeric data entry and basic PC Literacy
Good problem-solving skills.
Ability to handle a variety of tasks with speed, attention to detail and accuracy.
B.
Other
A.
Excellent time management skills to handle high workload volume.
Self-directed, attention to detail
Excellent interpersonal communications skills with ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives.
Ability to empathize with patients in need of care.
WORKING ENVIRONMENT
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares.
Under the supervision of the Business Services Supervisor, the Prior Authorization Specialist (PAS) is responsible for processing incoming referral requests to obtain prior authorizations from health plans, document and complete incoming referral requests, timely, accurately and efficiently and to communicate referral outcomes with internal and external customers, as needed. The PAS will accurately verify and document in the practice management system all pertinent information conducive to proper claim adjudication by the health plan. The PAS initiates communication with the clinic/physician when a referral is denied and/or requires additional information, Peer to Peer Review, etc. The PAR will be logging in to the designated phone queue to answer, direct and/or resolve any inquiries or directions regarding referrals.
Additional duties include handling and appropriately directing referral status requests as needed.
Qualifications:
Additional duties include handling and appropriately directing referral status requests as needed.
Prior Authorization Specialist
Location: Pearland Administrative Office
Department: Central Business Office
Job Type: Full Time
Job Type: Full Time
Salary Range:
$37,668.80 to $46,529.60
(Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Education
A.
High School diploma or GED from an accredited institution
B.
College level courses
Experience
A.
2 years of medical office experience either in a physician office or hospital setting, health plan, ACO, or other managed care setting.
Experience navigating payor web portals.
B.
Knowledge of CPT & ICD 10 Coding methodologies.
Prior experience with precertification and/or utilization management.
Licenses
A.
B.
Epic System usage.
Special Skills
A.
Working knowledge of medical terminology and HMO/ PPO authorization processes.
Excellent communication skills
Alpha/numeric data entry and basic PC Literacy
Good problem-solving skills.
Ability to handle a variety of tasks with speed, attention to detail and accuracy.
B.
Other
A.
Excellent time management skills to handle high workload volume.
Self-directed, attention to detail
Excellent interpersonal communications skills with ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives.
Ability to empathize with patients in need of care.
B.
WORKING ENVIRONMENT
Office
colinoncars.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, colinoncars.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, colinoncars.com is the ideal place to find your next job.