Prior Authorization Specialist (2762)
On-site · Houston, Texas, United States
Houston, Texas, United StatesOn-siteFull TimeMid LevelHigh School Or EquivalentSmall
Type
Full Time
Level
Mid Level
Education
High School Or Equivalent
Company size
Small
Job Summary
Responsible for ensuring timely and accurate insurance authorizations prior to services, verifying eligibility and benefits, handling pre-certification and referral requirements, coordinating with payer and clinical teams, documenting thoroughly, and mentoring staff as needed in a Cardiology/vascular setting.
Required Qualifications
- High School Diploma or equivalent
- Associate’s degree in healthcare administration or business administration preferred
- 3-5 years' experience in the same role, or related field in a healthcare setting required
- ECW experience preferred
- Familiarity with medical office procedures and billing practices
- Proficient in clinical documentation review for alignment with insurance authorization requirements
- Regulatory compliance knowledge (OSHA, HIPAA, Federal Fraud and Abuse laws)
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