Prior Authorization Specialist - Endocrinology at Emerson Hospital – Maynard, Massachusetts

Reporting to the Office Manager, the Prior Authorization specialist is responsible for obtaining prior authorizations for all medication with all commercial payers.

• Education
  • High School Diploma or equivalent preferred
• Experience
  • 2 years’ experience in medical field required
  • Medication Prior Authorization experience preferred
  • Knowledge of prior authorization and its direct impact on the practice’s revenue cycle
• Licensure and/or Certification
  • No licensure required
• Skills
  • Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
  • Proficient use of CPT and ICD-10 codes - Proficiency in the use of computers and basic software applications is necessary.
  • Excellent computer skills including Excel, Word, and Internet use
  • Detail oriented with excellent organizational skills
  • Plans and prioritizes to meet deadlines
  • Communicates clearly and effectively
  • Ability to multitask and manage high-volume, time-sensitive workload independently
  • Ability to be flexible and work within a team-focused, participative management framework is required.
  • Excellent customer service skills.
  • Must be able to read, write, and communicate in English.
  • Ability to maintain confidential information.