Prior Authorization Specialist Job at TEKsystems, Washington DC

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  • TEKsystems
  • Washington DC

Job Description

Description + Precertification is the pre-service checklist + Authorizations is setting up the auths, they would love if they have experience in Oncology, Radiation Oncology or Radiology Authorizations + Need to be familiar with online portal auths and not just over the phone. + Experience with Insurance and Managed Care, this is key. + Complexity of the authorization/ pre-cert is more important than the volume- + Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. + Complies with governmental and accreditation regulations. + Acts as a liaison during patient encounters by utilizing office policies and procedures. Greets each patient in a friendly manner and verifies that each patient's demographic and insurance information is correctly entered into the Practice Management System. + Schedules appointments and/or procedures by entering all relevant patient information in the Practice Management System to ensure proper preparation of the medical record and billing information prior to the time of appointment or procedure. + Answers the telephone with a positive and professional tone of voice before the fourth ring and directs or resolves the call appropriately in order to ensure each call is handled efficiently. + Enhances continuity of care for patients by utilizing the Practice Management System integrated functions to include: recalls, confirmations, wait lists and online appointments. + Interacts with practice employees, physicians, and others by obtaining and communicating essential data and assisting other team members to coordinate efficient patient flow through the practice. + Maintains a regulatory/compliance environment by following organizational policies and procedures to ensure compliance to state, local, and federal standards and regulations. + Obtains, identifies, and forwards referrals and authorizations to the A/R Department within 2 days of date of service by reviewing dates, billed procedures listed, signature of the referring physician, and batching worksheets to ensure claims are mailed from the A/R Department with appropriate documentation. + Performs check-out procedures by inputting patient charges and verifying patient demographic and insurance information in the Practice Management System, ensuring charges are entered within two days of date of service. Confirms each patient has an understanding of our co-pay, balance and billing procedures in compliance with the Collections Policy Manual. Skills Epic, Prior authorization, Customer service, medical, patient information, medical terminology, precertification, insurance verification, authorizations Top Skills Details Epic, Athena or Cerner experience preferred Prior authorizations, Customer service, Medical office, Patient information Additional Skills & Qualifications Associates degree required (will need proof of documentation of COMPLETED Associates' degree) Top 3 skills: 1. Care coordination/case management 2. Experience with single case agreements 3. 2+ years experience in Insurance/ authorization experience Must have good organization, attention to detail, thick skin, and empathetic with patients. Must be outgoing and good communication skills. Experience Level Intermediate Level Job Type & Location This is a Contract to Hire position based out of Washington, DC. Pay and Benefits The pay range for this position is $25.00 - $30.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Washington,DC. Application Deadline This position is anticipated to close on Dec 2, 2025. h4> About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Job Tags

Contract work, Temporary work, Work at office, Local area,

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