Eligibility & Prior Authorization Specialist Job at Hera Women's Health, Las Vegas, NV

SjJYVnFWRTdGbWc0T2VsY2piRXRJbFZ6c2c9PQ==
  • Hera Women's Health
  • Las Vegas, NV

Job Description


Job Title: Eligibility and Prior Authorization Specialist
Location: Las Vegas, NV
Job Type: Full-Time
Job Summary:
My OBGYN is seeking a detail-oriented and knowledgeable Eligibility and Prior Authorization Specialist to join our practice. The ideal candidate will be responsible for verifying patient benefits, obtaining prior authorizations for procedures and medications, and ensuring compliance with insurance guidelines.
Responsibilities:
  • Verify patient insurance benefits and coverage for OBGYN services, including office visits, diagnostic tests, and surgical procedures.
  • Obtain prior authorizations and pre-certifications for procedures, treatments, and medications as required by insurance providers.
  • Communicate with insurance companies, patients, and healthcare providers to resolve any authorization or benefits-related issues.
  • Maintain accurate records of authorizations, approvals, and denials in the electronic health record (EHR) system.
  • Educate patients about their insurance benefits, coverage limitations, and out-of-pocket costs.
  • Work closely with the billing department to address claim denials related to authorization issues.
  • Stay up to date with insurance policies, coding changes, and payer requirements.
  • Provide administrative support to the practice as needed, including scheduling and coordinating patient services.
Requirements:
  • This position is based in our Centennial Hills office. Candidates must be able to reliably commute. 
  • Minimum of 1 year of experience in completing prior authorization for a medical facility; PREFERRED  in an OBGYN or women’s health setting.
  • Medical Assistance experience PREFERRED
  • Strong understanding of insurance policies, prior authorization processes, and medical billing.
  • Proficiency in electronic health records (EHR) preferably AthenaOne.
  • Excellent communication and customer service skills.
  • Strong attention to detail and ability to work efficiently in a fast-paced environment.
Benefits:
  • Competitive salary based on experience
  • Health, dental, and vision insurance
  • 401(k) with employer matching after 1 year of service
  • Paid time off (PTO) and holidays

Job Tags

Full time, Work at office,

Similar Jobs

Interim HealthCare of Central VA

CNA / PCA Job at Interim HealthCare of Central VA

CNA / PCA In Verona and surrounding areas! If caring for others comes natural to you, this is an ideal career opportunity! As a PCA, youll earn competitive...  ...helping individuals live safely and happily at home. From bathing and dressing to meals and companionship... 

NexCare WellBridge Senior Living

Dietary Order Clerk Job at NexCare WellBridge Senior Living

Join our AWARD WINNING team at Valley View Care Center National Quality SILVER Award Winners! The Dietary Order Clerk is our Culinary Concierge who is responsible for being in charge of capturing meal orders for our residents and guests.Our patients and guests...

Life Advancement Group

SEO Specialist Job at Life Advancement Group

 ...Education: Undergraduate Degree Base Pay: $50k to $60k Salary Send applications or inquiries to: ****@*****.*** SEO SPECIALIST POSITION OBJECTIVE The SEO Specialist is responsible for managing and optimizing all aspects of SEO to enhance website... 

Donatos Pizza

Production team member nights Job at Donatos Pizza

Donatos Pizza - Immediate Team Member Needed Are you looking for a fun and dynamic work environment where you can grow and thrive? Do you enjoy serving customers with a smile and being part of a loving team? Paisan Pizza dba Donatos of Lima Marysville and Piqua is seeking...

ONESOURCE DISTRIBUTING LLC

Very Part Time Merchandiser in the Bethlehem, PA area Job at ONESOURCE DISTRIBUTING LLC

 ...Distributing Merchandiser SUMMARY : This very part time position is primarily responsible for receiving and displaying the Eyewear, Greeting Cards, and Jewelry. shipments for their assigned store(s). As well as, assisting with any customer service requests related to...