Referral/Prior Authorization Specialist - Monadnock Gastroenterology Associates - Per Diem
On-site · Peterborough, New Hampshire, United States
Job Summary
The Referral/Prior Authorization Specialist is responsible for managing referrals and prior authorizations, ensuring they are timely and accurate. Key responsibilities include telephonic support for online authorizations, educating and supporting Primary Care practices and specialty care providers, verifying member eligibility, determining benefit coverage, and processing physician referral orders using eCW. This role requires knowledge of medical terminology, proficiency with ICD-9/ICD-10 and CPT codes, and a strong understanding of medical office procedures.
Required Qualifications
- Proficiency in ICD-9/ICD-10 and CPT codes
- Knowledge of medical terminology
- High proficiency in general medical office procedures including HIPAA regulations
Additional Requirements
- Must be able to perform duties as required
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