Renew Pain Solutions LLC Prior Authorization Coordinator Greenville, SC · Full time Company website

Oversee prior authorizations and insurance coordination

Description

Success Profile

The Prior Authorizations Coordinator plays a crucial role in ensuring that patients receive timely approval for medical procedures, treatments, and medications from insurance providers. This position requires previous prior authorization experience specifically related to surgical proecedures. Additionally, excellent communication skills, strong attention to detail, and the ability to work collaboratively with healthcare providers, insurance companies, and patients is a must. This role demands a professional who can maintain a humble service-minded approach, and communicate effectively with vendors, patients and the internal team. 


Expected Daily Responsibilities:

  • Manage the entire prior authorization process, including gathering necessary documentation, completing authorization forms accurately, and submitting requests to insurance companies within designated timelines.
  • Verify patients' insurance coverage and eligibility for specific procedures, treatments, or medications requiring prior authorization.
  • Establish and maintain effective communication channels with insurance companies to follow up on prior authorization requests, provide additional information as needed, and advocate for patients' needs.
  • Collaborate with healthcare providers to obtain required medical records, clinical documentation, and supporting information necessary for prior authorization requests.
  • Provide clear and comprehensive explanations to patients regarding the prior authorization process, including potential delays, requirements, and outcomes, to ensure informed decision-making.
  • Maintain accurate and up-to-date records of prior authorization requests, approvals, denials, and appeals in the electronic medical records (EMR) system.
  • Ensure compliance with all relevant healthcare regulations, privacy laws, and insurance guidelines related to prior authorizations.
  • Identify opportunities for process improvement in the prior authorization workflow to streamline operations, reduce delays, and enhance patient satisfaction.


We expect the Coordinator to:

  • Be action-oriented, with a constant focus on service to our patients
  • Maintain authenticity and humility, fostering a culture that encourages feedback and collaboration
  • Be trustworthy and dependable, maintaining confidentiality at all times
  • Be a learner, ask questions, and consistently look for opportunities for personal and professional growth
  • Look for ways to create efficiencies in their role


Salary

$20 - $22 per hour