Labcorp Pre Authorization Specialist- ONSITE/BUFFALO, NY (onsite 3 days a week- 2 days WFH)) in McLeansville, North Carolina
Insurance Verification and Authorization
Verify benefits through insurance online portals and phone systems
Authorization request preparation and submission
Follow up on open auth requests
Obtain clinical information necessary to support medical necessity
Compile and submit appeals for denied prior
Document insurance benefits and prior auth results
Locate and review payer medical policy, identify areas of change
Identify opportunities for payer education to develop medical policy
GENERAL INFORMATION: This position is responsible for assisting with the development and implementation of processes and procedures for pre-authorization / pre-verification of a variety of specialty laboratory tests for a division. Monitors pricing changes and patient payments to prevent bad debt. Oversees billing waivers for Self-pay patient / special pay patient. Prepares monthly corporate and divisional reporting for management. Identifies and analyzes trends. Notifies management of any that may impact timelines or deliverables. Provides additional reporting as requested for stakeholders to help guide decisions. Educates clients on payer policies and the pre-authorization process to ensure correct billing and prompt payment.
High School or equivalent and with a minimum of 2 years of experience. Preferred: Associate's Degree in Business, Finance, Healthcare Administration or related field plus a minimum of 3 years experience in healthcare industry.
Monday-Friday; 8:00am-4:30pm; Base location is Buffalo NY
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.
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