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An opthalmology (retina only specialty ) practice is seeking an experienced RemotePrior Authorization Specialist to join our team. The core of this role is responsibility for managing and submitting prior authorizations for retinal procedures, including injection drugs, surgery, laser, exams, or any other types of procedures. Other parts of the role is managing medication assistance program funds, medication inventory system managment, etc. The ideal candidate will have a strong understanding of insurance requirements, excellent attention to detail, and current or prior experience submitting and manageing authorizations for a retina practice.
Responsibilities:
Submit and manage prior authorization requests for retinal injections, procedures, imaging, and medications
Communicate with insurance companies to verify coverage and authorization requirements
Follow up on PA denials and appeals
Track authorization status and follow up on pending requests
Work closely with clinical staff and providers to ensure timely patient care
Maintain accurate documentation within the EHR system
Identify and resolve authorization denials and assist with appeals when necessary
Stay current with payer policies and prior authorization guidelines
Some scheduling, answering phones, or other adminstrative tasks may be required
Work with medication inventory systems
Work with patient assistance funding programs on behalf of our patients
Qualifications:
Required: Prior authorization experience in a Retina Practice (or multi speciality eye practice that included Retina)
Positive interactions and communication skills amongst staff
Strong knowledge of insurance plans, payer requirements, and medical terminology
Experience with specialty medications and procedure authorizations
Ability to manage multiple authorizations and meet deadlines in a fast-paced environment
Strong communication and organizational skills
Experience with electronic health records (EHR)
Ability communicate effectively and positively with clinical staff, physician, and management
Pay: $18.00 - $23.00 per hour
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Flexible schedule
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Application Question(s):
Ability to communicate in a professional and customer service oriented manner
Work effectively and maintain work standards in a remote/work from home environment
Experience:
Retina specific Prior Auth: 1 year (Required)
Language:
Professional/Business English clearly and effectively (Required)
