Medical Claims Officer (Pre-Authorization Officer)
Job Description
The Officer, Pre-Authorization, ensures timely and accurate submission of pre-authorization requests, supporting efficient patient care.
Responsibilities
- Stay updated on medical codes and regulatory standards.
- Ensure accurate and timely submission of pre-authorization requests.
- Verify request accuracy, including required documents and patient information.
- Coordinate with clinical teams to clarify procedures and diagnoses.
- Track and follow up on prior authorization requests proactively.
- Communicate with insurance companies, clinicians, and patients as needed.
- Document and maintain authorization details in the hospital system.
- Comply with health, safety, and infection control regulations.
Qualifications
Education: Healthcare professional with Bachelor degree or graduate with an accredited Diploma course from a related healthcare field
Experience: 2 years of relevant experience in a similar role
Certificate and Licensure: Regularly updated Certificate in Coding from accredited institutions
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