Prior Authorization Specialist
Core
Obtain insurance approvals for Adaptive Biotechnologies' clonoSEQ MRD Assay to facilitate patient access to essential laboratory services.
Role type
Prior Authorization Specialist
Builds
Insurance approvals for molecular and genetic testing services
Domain
Healthcare / Life Sciences / Molecular Diagnostics
Deliverable
client delivery
Required skills
Prior authorization processes, medical billing, insurance verification, medical terminology, EMR systems, Microsoft Office Suite
Preferred skills
Careviso, Glidian, Quadax systems, molecular or genetic testing experience
Responsibilities
Submit and track prior authorization requests, review clinical documentation for payer compliance, communicate with insurance companies to resolve issues, maintain accurate records in RCM system, identify and escalate denial trends, assist in developing workflow best practices
Seniority
Individual Contributor, 2+ years experience