Work whereevery momentmattersEvery day almost Hartford HealthCare employees come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticuts most comprehensive healthcare networkHartford HealthCare Medical Group is one of the largest medical practices in New England with multiple locations throughout Connecticut and Rhode Island We consist of a team of professionals ranging from Medical Assistants to Physician Assistants and everything in between Our physician led medical group enjoys an excellent reputation with patients and the medical community offering primary care urgent care and more than different specialtiesJob DescriptionUnder the direction of the Manager a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures medications and any surgical services in a timely mannerResponsible for creating maintaining and managing resources including insurance portal access Must have consistent documentation in EPIC to support the obtained insurance authorization Will communicates changes in payer and or federal regulatory guidelines to their manager providers and other clinical departments as applicablemiddot Monitors and reviews the prior authorization work queue daily to verify accuracy of patientrsquos insurance information and to interpret insurance pre authorization requirements for scheduled procedure surgery and or medicationmiddot Contacts insurance companies to obtain prior authorization via telephone andor portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled date of proceduremiddot Documents in EPIC prior authorization information obtained such as number of treatments authorized length of time treatment is authorized authorization numbers and insurance company contact or call reference numbermiddot Immediately communicates to provider when a procedure medication or surgery is denied by the insurance company Assists in setting up peer to peer reviewsmiddot Collaborates and communicates with pharmacy regarding preferred drugs on the particular insurance plan and notifies providers of alternativesmiddot Maintains log of missed prior authorizations and assists manager with timely retro authorizations or appeals to recoup revenuemiddot Collaborates with various hospital departments around billing information management policies procedures and general operations related to prior authorizationsmiddot When time allows can help out in the office with managing incoming phone calls baskets and other front desk coverage answering phones and transcribing orders and referrals middot Monitoring referral work queue registering arriving patients answering incoming calls as well as other assigned duties as needed Work whereevery momentmattersEvery day almost Hartford HealthCare employees come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticuts most comprehensive healthcare networkHartford HealthCare Medical Group is one of the largest medical practices in New England with multiple locations throughout Connecticut and Rhode Island We consist of a team of professionals ranging from Medical Assistants to Physician Assistants and everything in between Our physician led medical group enjoys an excellent reputation with patients and the medical community offering primary care urgent care and more than different specialtiesJob DescriptionUnder the direction of the Manager a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures medications and any surgical services in a timely mannerResponsible for creating maintaining and managing resources including insurance portal access Must have consistent documentation in EPIC to support the obtained insurance authorization Will communicates changes in payer and or federal regulatory guidelines to their manager providers and other clinical departments as applicablemiddot Monitors and reviews the prior authorization work queue daily to verify accuracy of patientrsquos insurance information and to interpret insurance pre authorization requirements for scheduled procedure surgery and or medicationmiddot Contacts insurance companies to obtain prior authorization via telephone andor portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled date of proceduremiddot Documents in EPIC prior authorization information obtained such as number of treatments authorized length of time treatment is authorized authorization numbers and insurance company contact or call reference numbermiddot Immediately communicates to provider when a procedure medication or surgery is denied by the insurance company Assists in setting up peer to peer reviewsmiddot Collaborates and communicates with pharmacy regarding preferred drugs on the particular insurance plan and notifies providers of alternativesmiddot Maintains log of missed prior authorizations and assists manager with timely retro authorizations or appeals to recoup revenuemiddot Collaborates with various hospital departments around billing information management policies procedures and general operations related to prior authorizationsmiddot When time allows can help out in the office with managing incoming phone calls baskets and other front desk coverage answering phones and transcribing orders and referrals middot Monitoring referral work queue registering arriving patients answering incoming calls as well as other assigned duties as needed middot High School GraduateDiploma preferredmiddot At least one year experience working with insurances and prior authorizations preferredmiddot Experience and knowledge of insurances and prior authorizationsmiddot Ability to effectively and professionally communicate with physicians clinical and administrative staff managers patients and insurance companiesmiddot Must be self motivated and have the ability to work independently and within a teammiddot Demonstrates excellent telephone computer organization and customer service skillsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this is yourmomentmiddot High School GraduateDiploma preferredmiddot At least one year experience working with insurances and prior authorizations preferredmiddot Experience and knowledge of insurances and prior authorizationsmiddot Ability to effectively and professionally communicate with physicians clinical and administrative staff managers patients and insurance companiesmiddot Must be self motivated and have the ability to work independently and within a teammiddot Demonstrates excellent telephone computer organization and customer service skillsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this is yourmoment