Job Description
The Prior Auth specialist would be responsible for managing end-to-end prior authorizations, including reviewing clinical documentation, identifying the correct ICD and CPT codes, submitting requests through payer portals, tracking pending cases, following up proactively, handling denials and appeals when needed, and coordinating closely with schedulers and providers to prevent delays in care. Key
7:00 AM
Review the surgical and procedure schedule for the next 48β72 hours. Every case that requires authorization needs to be cleared beβ¦
7:30 AM
Pull the PA worklist. Filter by date of service β cases with the earliest service dates get worked first. High-cost procedures (suβ¦
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them allβ¦
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