Prior Authorization Specialist - East Mason - Prevea Health

Prior Authorization Specialist

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Come work where we specialize in you!
We have nearly 2,000 reasons for you to consider a career with Prevea Health—they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care.



Job Summary
Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization. All members are expected to focus on the patient's needs; relate to all in a friendly, accepting manner; communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; and demonstrate an overall high level of performance.


What you will do

• Works closely with department physicians and staff, coding and billing staff, to ensure understanding of information needed to obtain proper authorization for payment.


• Communicates with patients prior to specialty consultation or surgical procedure to provide them with information regarding their coverage.


• Identifies what is required for Preauthorization of surgical procedures and completes the process to minimize denial of claims.


• Preauthorization documentation.


• Communicate with hospitals and patient on progress/approval of Preauthorization.

Education Qualifications

• High School Diploma and/or GED Required

Experience Qualifications

• 1-3 years One year of experience in a medical or insurance role Preferred

Skills and Abilities

• General computer knowledge needed to navigate electronic medical record and for documentation.


• Excellent organizational skills.


• Excellent communication skills and follow through with internal and external customers.


• Knowledge of insurance and medical terminology.


• Knowledge of CPT/ICD-9 coding useful.

Physical Demands

• Sit - Constantly


• Stand - Rarely


• Walk - Rarely


• Drive - Rarely


• Climb (Stairs/Ladders) - Rarely


• Bend (Neck) - Frequently


• Gross Manipulation (Hands/Arms) - Constantly


• Squat - Rarely


• Twist/Turn (Neck) - Occasionally


• Lift/Carry 0-10 lbs. - Rarely


• Lift/Carry 11-25 lbs. - Rarely


• Lift/Carry 26-35 lbs. - Rarely


• Push/Pull up to 10 lbs. - Rarely


• Push/Pull 11-25 lbs. - Rarely


• Push/Pull 26-35 lbs. - Rarely


• Reach (Above shoulder level) - Rarely


• Reach (Below shoulder level) - Constantly


• Simple Grasping (Hands/Arms) - Constantly


• Fine Manipulation (Hands/Arms) - Constantly


• Gross Manipulation (Hands/Arms) - Constantly

Working Conditions

• Noise - Occasionally

Hearing Requirements

• Hears Whispers < 3 feet - Constantly


• Hears Whispers 3-8 feet - Constantly

Vision Requirements

• Color Discrimination - Constantly


• Near Vision (Correctable to Jaeger 2 or 20/30 binocular) - Constantly


• Distance Vision (Correctable to Snellen chart 20/30 binocular) - Constantly

Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify


Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled