Family Eye Physicians
Prior Authorization and Referral Specialist
Family Eye Physicians, Oak Brook, Illinois, United States, 60523
Prior Authorization and Referral Specialist
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Prior Authorization and Referral Specialist
role at
Family Eye Physicians . This is a full‑time, onsite position in Oak Brook Terrace, IL. In this role you will request and complete authorizations and referrals for our ophthalmology practice, ensuring we have the prior authorization and/or referral needed to move forward with patients’ appointments or procedures.
Key Responsibilities
Review appointment schedules and process prior authorization requests for medical services
Verify patient insurance coverage and eligibility for requested services
Monitor schedules for potential issues prior to appointment date
Interact with insurance companies to submit authorization requests and follow up on pending approvals
Contact referring physicians for additional information as needed
Maintain accurate records of authorization requests and outcomes in the electronic health record (EHR) system
Assist patients, internal staff, and physicians in understanding authorization requirements and processes
Collaborate with the billing team to resolve authorization‑related issues and ensure continuity of care
Provide training and support to new staff on prior authorization procedures
Prepare reports and analyze data related to authorization trends and outcomes
Qualifications
High school diploma or equivalent; associate’s degree in a relevant field preferred
Previous experience (1‑2 years) in a prior authorization or medical billing role is highly desirable
Strong knowledge of medical terminology, coding, and insurance regulations
Excellent communication and interpersonal skills
Detail‑oriented with strong organizational and time‑management abilities
Proficient in using EHR systems and Microsoft Office Suite; knowledge of Nextech / Practice Plus preferred
Proficient in utilizing insurance portals including Availity, UHC, Humana, Cigna
Ability to work independently and as part of a team in a fast‑paced environment
Seniority level Entry level
Employment type Full‑time
Job function Health Care Provider
Industry Wellness and Fitness Services
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Prior Authorization and Referral Specialist
role at
Family Eye Physicians . This is a full‑time, onsite position in Oak Brook Terrace, IL. In this role you will request and complete authorizations and referrals for our ophthalmology practice, ensuring we have the prior authorization and/or referral needed to move forward with patients’ appointments or procedures.
Key Responsibilities
Review appointment schedules and process prior authorization requests for medical services
Verify patient insurance coverage and eligibility for requested services
Monitor schedules for potential issues prior to appointment date
Interact with insurance companies to submit authorization requests and follow up on pending approvals
Contact referring physicians for additional information as needed
Maintain accurate records of authorization requests and outcomes in the electronic health record (EHR) system
Assist patients, internal staff, and physicians in understanding authorization requirements and processes
Collaborate with the billing team to resolve authorization‑related issues and ensure continuity of care
Provide training and support to new staff on prior authorization procedures
Prepare reports and analyze data related to authorization trends and outcomes
Qualifications
High school diploma or equivalent; associate’s degree in a relevant field preferred
Previous experience (1‑2 years) in a prior authorization or medical billing role is highly desirable
Strong knowledge of medical terminology, coding, and insurance regulations
Excellent communication and interpersonal skills
Detail‑oriented with strong organizational and time‑management abilities
Proficient in using EHR systems and Microsoft Office Suite; knowledge of Nextech / Practice Plus preferred
Proficient in utilizing insurance portals including Availity, UHC, Humana, Cigna
Ability to work independently and as part of a team in a fast‑paced environment
Seniority level Entry level
Employment type Full‑time
Job function Health Care Provider
Industry Wellness and Fitness Services
#J-18808-Ljbffr