Prior Authorization Specialist I (On-Site)

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13712098 GENERAL DESCRIPTION The Prior Authorization Specialist I is responsible for diagnostic and procedure orders management, including completing prior authorizations, scheduling appointments, obtaining order results, and submitting results to the ordering provider. The Prior Authorization Specialists I assists patients with applications for programs to support the financial obligations needed to complete screening exams, and scheduling in-house diagnostic exams. Requirements ESSENTIAL DUTIES - Reviews order within the Electronic Health Record System with insurance companies to determine need for prior authorization. - Processes prior authorizations and sends any supporting documentation to insurance companies to expedite the prior authorization process. - Schedules diagnostic imaging and procedure appointments appropriate for the patients needs, internally or externally. - Manage correspondence with insurance companies, physicians, specialist and patients, as needed, including documenting in the EHR as appropriate. - Reviews denials and follows up with the provider to obtain medically necessary information to submit an appeal of the denial. - Prioritizes orders by level of urgency. - Requests order results from external facilities and submits the results to the order provider to support continuation of care. - Assists patients with program applications to finance screening diagnostic imaging exams.