Prior Authorizations Specialist - Neurosurgery

Hartford Healthcare -  -  - Responsibilities:
Monitor and review the prior authorization work queue daily to verify accuracy of patients insurance information and interpret insurance pre-authorization requirements for scheduled procedures, surgeries, or medications.;
Contact insurance companies to obtain prior authorization via telephone and/or portals and provide necessary clinical documentation to ensure authorization is obtained prior to the scheduled date of procedure.;
Document in EPIC prior authorization information obtained, including number of treatments authorized, length of time treated, authorization numbers, and insurance company contact or reference number.;
Immediately communicate to providers when a procedure, medication, or surgery is denied by the insurance company; assist in setting up peer-to-peer reviews.;
Collaborate with pharmacy regarding preferred drugs on the particular insurance plan and notify providers of alternatives.