Job Description

Primary City/State: Phoenix, Arizona

Department Name: Prior Authorization Svcs-Ref L

Work Shift: Day

Job Category: Revenue Cycle

Want to be supportive and supported? Come work with purpose, helping our patients in this prior authorization analyst role.

POSITION SUMMARY

This position is responsible for obtaining and retrieval of all prior authorizations necessary for performing testing and claim adjudication. Contact with the appropriate insurance health plans including but not limited to faxing appeals, calling insurance companies to verify information (fax numbers, mailing addresses, etc.), on-line portal methods, and client contact for medical record requests and other necessary documentation required to secure a prior authorization. The scope of this position is inclusive of other administrative duties to help support the Revenue Team as needed. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.

MINIMUM QUALIFICATIONS

• High School diploma.
• Three (3) years\xe2\x80\x99 of related experience in medical billing or in a healthcare setting.
• Three (3) years\xe2\x80\x99 of related experience in insurance collections including resolution of denials and the filing of claim appeals.
• Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines.

PREFERRED QUALIFICATIONS

• Associate\xe2\x80\x99s Degree in related field.
• Five (5) years\xe2\x80\x99 of related experience in medical billing or in a healthcare setting.
• Extensive knowledge of clinical laboratory operations.
• Five (5) years\xe2\x80\x99 of related experience in insurance collections including resolution of denials and the filing of claim appeals.
• Advanced working knowledge of Xifin.

• ICD-10 Certification.

Our organization supports a drug-free work environment.

Sonora Quest