Prior Authorization Specialist - Insight Global : Job Details

Pay Rate: 18hr-27hr

-Onsite Charlottesville, VA 5 days/ week

Insight Global is seeking a Prior Authorization Specialist for one of the Top ranked transplant programs in the state. This role is local to Charlottesville, Virginia. The Prior Authorization Specialist will be responsible for managing future and current transplant recipients financial journey. This includes initial screening of potential transplant patient, working with clinicals on the selection committee for transplants and reporting on potential patients financial standing. Once a patient is identified they will work with the patient and insurance companies on the financial clearance. The day to day responsibilities are:

• Performs financial screening/interview of all patients presenting for transplantation.
• Researches and verifies insurance for hospital professional and pharmacy coverage
• Acts as a contact for insurance case managers primarily including but limited to obtaining pre-certification. Collects and submits necessary documentation and correspondence. Performs and communicates related follow-up.
• Assists finance department by providing data about transplant program and financial activities to support insurance contacts.
• Implements and coordinates the reimbursement of approved contracts with Director of Patient Accounts
• Sit in on selection committee meetings and present the transplant candidates financial background
• Meet with patients in clinic and clear them for the transplant and explain the additional costs associated with receiving a transplant.

Must Haves:

-High School Diploma

-Insurance Verification/ prior authorization experience in transplant, surgery, or cardiology departments

-Epic experience

-presentation experience

Nice to have:

-Experience with verifying immunosuppressant medication