Insurance Pre-Authorization Representative

Prepares referrals/FMLA/disability forms per payer criteria for designated providers ensuring timely response to requests and meets established turnaround time.

Prepares pre-authorizations and FMLA/disability forms per health care guidelines/established laws for designated providers to build timely approvals/forms completion in order to preserve and generate revenue and maintain patient satisfaction.

Prioritizes the processing of referral requests/FMLA disability forms based on medical necessity and/or urgency of the patient case.

Communicates status of authorization/FMLA disability forms (approvals, denials, pending) to patients, physicians and other clinical staff.

Addresses all tasks, phone calls, voicemail and e-mail within established timeframes and per current department guidelines

Collaborates with physicians and staff as well as outside offices to obtain needed information.

Establishes, develops and maintains good working relationships with hospital departments, health plan representatives and physician office personnel as well as a high degree of customer service/recovery skills.

Maintains patient confidentiality

Associate's degree Preferred

1 Year of experience in a medical office setting And

1 Year Prior Epic experience

Strong customer service focus

Detail oriented

Ability to multi-task and work in a fast paced environment

Strong oral and written communication skills

Ability to maintain confidentiality

High level of understanding of FMLA/Disability laws and processes

Medical terminology

Bilingual