Practice Prior Authorization Specialist - Ophthalmology, Allentown/easton
St. Luke's University Health Network
Allentown, PA, USA
Prior authorization coordination
Insurance verification and eligibility
Electronic health record (ehr) documentation
The Practice Prior Authorization and Referral Specialist is responsible for coordinating prior authorizations and referrals for patients requiring specialty care, medications, and diagnostic procedures
Job Summary
The Practice Prior Authorization and Referral Specialist is responsible for coordinating prior authorizations and referrals for patients requiring specialty care, medications, and diagnostic procedures.
The role involves verifying insurance information, obtaining pre-authorizations, scheduling, and documenting approvals in the electronic health record to ensure proper reimbursement.
St. Luke's is committed to excellence in patient care, education, and improving access to healthcare regardless of a patient's ability to pay.
Matching Summary
The Practice Prior Authorization and Referral Specialist is responsible for coordinating prior authorizations and referrals for patients requiring specialty care, medications, and diagnostic procedures.
Skills & Requirements
Must-have
Prior authorization coordination
Insurance verification and eligibility
Electronic health record (EHR) documentation
Patient care coordination
Collaboration with scheduling and pre-encounter departments
Nice-to-have
Knowledge of ICD 10 and CPT codes
Understanding of regulatory standards and compliance
Experience with medical billing
Strong communication with patients and providers
Key Requirements
High school diploma or equivalent
One to two years medical billing or insurance experience preferred
Working knowledge of medical office procedures
Understanding of ICD 10 and CPT codes
Knowledge of regulatory standards and compliance requirements