Job Description
- Prior authorization submission:
Prepare and submit prior authorization requests to insurance companies, including necessary medical documentation, diagnosis codes, and treatment plans.
- Clinical review:
Analyze medical records to determine if a requested service or medication aligns with medical necessity guidelines and insurance coverage.
- Communication with providers:
Contact healthcare providers to gather additional information or clarify details regarding requested services for prior authorization.
- Follow-up with insurance companies:
Monitor the status of pending prior authorization requests and follow up with insurance companies to obtain timely approvals.
- Patient education:
Explain the prior authorization process to patients, including potential delays and necessary documentation.
- Documentation:
Maintain accurate records of all prior authorization requests, including patient information, insurance details, and approval status.
- Billing support:
Collaborate with billing staff to identify and resolve potential billing issues related to prior authorizatio
- Insurance verification:
Accurately verify patient insurance information, including eligibility, benefits, and coverage details.
Numbers & Facts
| Location | Fresno, California |
| Industry | Staffing/Employment Agencies |
| Company Size | 1 to 9 employees |
| Year Founded | 1992 |
| Website | https://www.careerstrategiesgroup.com |
About Company
Career Strtegies Group is a national, full service recruiting, outplacement and career services organization. The firm specializes in the career needs of attorneys, financial professionals, and C-suite and other senior executives. It also has a smaller recruiting operation for healthcare professionals and administrators in the NY, CT and NJ area. The firm has particular experience with professionals aged 50+, and in the area of career change for attorneys and professionals. Firm founder Bruce Blackwell is an original member of the career transitions team established by the New York City Bar Association, and is a noted author and lecturer on career issues for lawyers and other professionals.
Skills
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