Prior Authorization Specialist - Ambulatory
 Quadrant, Inc. | |
 United States, Virginia, Richmond | |
 Jun 16, 2025 | |
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Prior Authorization Specialist - Ambulatory Richmond, VA Pay From: $20 per hour MUST: The Prior Authorization Specialist - Ambulatory should have strong experience obtaining prior authorizations for Ambulatory and Hospital 3+ years of experience with obtaining prior-authorizations Must have knowledge of insurance carriers Prior Authorizations for Diagnostic Tests Prior Authorizations for Imaging Services Prior Authorizations for Prescriptions Strong experience obtaining Prior Authorizations for medications and writing up medical necessities Assisting providers with appeals for medications that need justifications for approvals and have exclusions Uploading and logging prior authorizations Comfortable returning patient's phone calls regarding prior authorizations for medications DUTIES: The Duties of the Prior Authorizations -Medical Assistant include but are not limited to the following: Answer phone calls and return voicemails Work with insurance companies and fill out Prior Authorization forms that include diagnosis, lab results and why a specific medication is required Work with providers to complete Authorizations with justifications to get approvals for medications that have exclusions from plans Assist provider with appeals of denials including medical necessities Log and upload prior authorizations Stay knowledgeable of insurance-approved medications and formulary changes Quadrant is an affirmative action/equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, status as a protected veteran, or status as an individual with a disability. "Healthcare benefits are offered to all eligible employees according to compliance mandated by the Affordable Care Act". | |