WelsCare LLC
Salt Lake City, UT, USA
Job Description Job Description Overview The Prior Authorization Specialist plays a crucial role at WELS Care LLC by ensuring that patients receive the necessary medical services and treatments through effective communication with insurance companies and healthcare providers. This position requires a strong understanding of medical terminology, coding systems, and the prior authorization process to facilitate timely approvals for patient care. Duties Review and process prior authorization requests for medical services, procedures, and medications. Communicate with healthcare providers to gather necessary documentation and clarify any discrepancies. Utilize knowledge of DRG (Diagnosis Related Group) to ensure accurate coding and billing practices. Maintain detailed records of all interactions with insurance companies and healthcare providers. Stay updated on changes in medical policies, regulations, and coding standards (ICD-9, ICD-10). Collaborate with medical...