Prior Authorization Coordinator
Remote Raven View all jobs
- Kenya
- Permanent
- Full-time
- Review patient insurance policies to determine specific prior authorization requirements based on CPT codes for all upcoming surgical procedures.
- Initiate prior authorization requests through provider portals, phone communication, or fax submission.
- Track and follow up on submitted authorization requests, ensuring approvals are obtained and properly attached and linked to the patient’s scheduled appointment.
- Prepare and submit appeals when authorization requests are denied or require reconsideration.
- Communicate with patients when necessary to explain the prior authorization process or request additional required information.
- Accurately document all prior authorization activities in patient charts to ensure the care team is informed prior to the patient’s appointment.
- Monitor Microsoft Teams chats for questions, clarifications, or appointment updates that may impact prior authorization status in real time.
- Strong attention to detail and organizational skills.
- Effective verbal and written communication skills.
- Proficiency with Microsoft Teams, Outlook, and Excel preferred.
- Strong problem analysis and resolution skills.
- Ability to effectively multitask while working across multiple computer-based information systems.
- Capacity to work independently and remain productive in a self-directed environment.