Prior Authorization Specialist

Talyst Richardson , TX 75080

Posted 2 months ago

Job Objective:

Talyst's purpose is to improve patient safety in all care environments. The company was founded in 2002 to provide easy-to-use, automated medication management systems to hospitals and pharmacies. As a commitment to patient health we have a RCM department dedicated to PreAuth specialty drugs for cancer patients.

A dedicated, handworker with a compassionate heart is just who we are looking for to provide daily pre-certification billing activities and communications between Talyst customers and insurance companies. Regularly obtain pre-certifications from insurance companies for services to be rendered at customer outpatient facilities for further patient treatment and project management planning.

Duties and Responsibilities:

  • Contact applicable insurance companies, through internet or phone depending on requirements, and relay pertinent patient information to them for billing and medical pre-authorization purposes.

  • Document information from insurance entities and gather into appropriate databases for approval or denial reference and further reporting needs.

  • Report daily to company and customer contacts the status of project work.

  • Upon regular receipt of patient data, create patient accounts with critical data for project organization in a centralized database.

  • Using great discretion and confidentiality, secure patient demographic and medical information in a manner consistent with HIPAA compliance and regulations.

  • Support and promote the Talyst values through positive interactions with both internal and external stakeholders on a regular basis.

  • Attend to other initiatives and goals as assigned.

Experience, Skills and

  • HS Diploma and 1+ year of professional work experience, preferably in an office setting.

  • Previous work in billing offices or in clinical settings, particularly cancer centers preferred.

  • Must be proficient in MS Word, Excel, Outlook, Internet browsing and search functions, and a good overall knowledge of searching and data entry functions in database programs.

  • Must have excellent phone/email communication skills and be customer service oriented.

  • Proven experience self-managing and motivating to work through independent projects.

  • Will work directly with supervisor, but must be able to work unsupervised

  • Excellent customer service skills, written and oral communications skills and an ability to interface both externally with customers and inter departmentally.

  • Willingness to assist with a variety of tasks

  • Experience working in a goal oriented, delivery focused, and dynamic environment.

Working Conditions:

The job conditions for this position are in a standard office setting. Employees in this position use PC and phone on an on-going basis throughout the day. No travel is expected.

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Prior Authorization Specialist