RCM Prior Authorization - SRKay Consulting Group

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Job Description

Review and process prior authorization requests for medical procedures, medications, and services.
Verify insurance coverage and eligibility for patients undergoing prior authorization.
Communicate with healthcare providers, insurance companies, and patients to gather necessary information for authorization.
Ensure all required documentation is complete and accurate according to insurance and regulatory requirements.
Track and monitor authorization requests and follow up as necessary to expedite approvals.
Collaborate with clinical staff and physicians to provide necessary clinical documentation for authorization.
Maintain updated knowledge of insurance policies, guidelines, and regulations related to prior authorizations.
Identify and resolve issues or discrepancies related to prior authorizations to minimize delays and optimize revenue cycle efficiency.