About this role
About Triton Medical Solutions
Triton Medical Solutions is a medical billing and revenue cycle management company based in Tempe, Arizona. Since 2011, we have supported practices nationwide, including dental, orofacial pain, TMJ, dental sleep medicine, and CBCT radiology providers billing medical insurance.
About the position
We are currently looking for an Independent Contractor to join us as a Prior Authorization Specialist. This position is responsible for coordinating and obtaining prior authorizations from insurance companies to help ensure patients receive timely access to medically necessary services and procedures.
Essential Functions
• Reviews procedure requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge. Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity.
• Establish contact with the physician’s office or customer service department to resolve issues concerning missing vital information from patient’s record.
• Contact insurance carriers to obtain necessary prior authorizations.
• Submits all authorizations with correct CPT and diagnosis codes.
• Review and take corrective action on denied prior authorizations.
• Maintain up to date information on various insurance companies and any relevant changes.
• Handle incoming and outgoing calls from internal team members, insurance payers and customers related to clinical documents and insurance benefits.
• Provides quality customer service to our clients.
• This position requires professionals to spend extensive amounts of time on the phone with insurance companies.
• Work cordially within a team and participate in meetings, sharing ideas and information.
• Ability to relate with people of diverse backgrounds, provide excellent customer service and solutions to problems.
• Participate in various projects and/or meetings, and complete other tasks as assigned by the Team Leader and/or management.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Qualifications
• Required: High school diploma.
• 1-2 years in customer service oriented environment preferred.
• 1-2 years working within the insurance industry in a provider’s office, insurance company, or company where you were involved with employee benefits is preferred.
• Ability to work independently, give attention to detail, prioritize and perform several tasks together without losing concentration.
• Knowledge of insurance cards, medical insurance terminology, medical benefits, and CPT and ICD 9/10 coding.
• Must be able to follow established procedures.
• Excellent typing and computer usage skills, including Microsoft Word and Excel proficiency.
• Must possess good oral and written (English) communication skills.
• Must be well organized and detail-oriented.
Expectations and Commitment
• As an Independent Contractor, you will be using your own computer that meets our IT requirements.
Position details
• Classification: Full-time Independent Contractor
• Work arrangement: Remote
• Hours: Approximately 40 hours per week
• Schedule: Flexible scheduling, subject to agreed-upon work requirements and deadlines.