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The specialist is responsible for verifying patient insurance eligibility and submitting prior authorization requests to providers. They must also track pending cases, resolve denials, and ensure clinical documentation meets insurance coverage requirements.
We are currently hiring for a prior authorization specialist to work at our Sharonville Headquarters. You will be responsible for obtaining necessary approvals from insurance providers prior to patients starting treatment or medications. You will review clinical documentation, submit authorization requests, and communicate with healthcare providers and payers to ensure coverage requirements are met. The role includes tracking requests, resolving issues and denials. This position can become remote once training is completed.
Minimum Qualifications:
Responsibilities:
Verify patient eligibility and coverage limits
Review medical charts to ensure clinical notes match what insurance requires
Send requests for prior approval to insurance providers
Track pending cases and follow up with insurance agents
Benefits:
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