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

Job Summary

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

Minimum Qualifications

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.