Job Functions, Duties, Responsibilities and Position Qualifications:

Clinical Pathology Laboratories (CPL) has a dynamic opening for a Customer Service Prior Authorization Specialist - Located in North Austin, TX

The Customer Service Prior Authorization Specialist is responsible for reviewing accessions for tests requiring prior authorization from insurance companies, coordinating with clients and insurance carriers to obtain prior authorizations. Provides accurate and timely information to supporting CPL departments, clients, patients, and Accounts Receivable. Adheres to departmental policies and procedures; follow-up on pending requests; provides status updates to Accounts Receivable. Delegation of tasks by leadership team as needed.

Essential Job Duties:

Utilizes billing and clinical resources and customer service skills to effectively and efficiently triage prior authorization requirements.

• Utilizes resources to identify accessions with testing that may require prior authorization
• Follows procedures for review, documentation and submission for prior authorization
• Reviews requisitions to determine billing information, including insurance carrier
• Reviews insurance requirements to determine if prior authorization is required
• Coordinates with client to obtain needed medical documentation
• Ability to accurately complete necessary paperwork to submit prior authorization request to insurance via phone, fax or website
• Timely follow-up with insurance carriers on pending prior authorization requests
• Timely notification of appropriate AR department of prior authorization status
• Proficiently operates computer and other office equipment
• Ability to positively meet the needs of CPL patients and clients through professional communication; respects and protects the confidentiality of information
• Ability to work with key work partners and resources to complete required tasks

Take a look at the qualifications and experience we require:

• Minimum – High School diploma or equivalent (GED)
• Preferred – Associates degree in the healthcare related field or laboratory or Medical Assistant training

Preferred skills we are looking for:

• Excellent customer service and communication skills
• Knowledge of insurance contract/policy
• Analytical and problem-solving skills
• Ability to cope with varied levels of workload and multi-tasking
• Ability to adapt to changing work environment
• Able to type at least 35 wpm - 88% accuracy rate

Physical Demands: Requires sitting or standing for long periods of time in a small cubicle or requires walking for long periods of time within the company. Requires manipulation of tools, objects, and equipment using the following physical motions: pushing, pulling, lifting, reaching above shoulder height, grasping with one hand or both, extensive typing, twisting and reaching. Routinely requires coordination of two or more physical operations. Requires ability to hear audible sounds via headset or telephone handset.

Environmental Demands: Works in a temperature controlled small and noisy environment. May be required to operate fire and safety equipment or follow other safety procedures in an emergency situation. May be required to work with time constraints and crisis situations.

We Offer:

• Competitive wages
• Medical, Dental, Vision, Life and AD&D, Short and Long Term Disability
• 401k Savings Plan and Employer Match
• Work-life balance, including Paid Time Off and Paid Holidays

COVID-19 Considerations: Wearing a mask is optional.

Excited about a career with a company that exemplifies its core values and offers a great total rewards package? Apply Now!

Scheduled Weekly Hours:

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Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.