[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-262149-105":53,"doc-detail-262149-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","prior-authorization-specialist-medical-coder-job-description","Prior-Authorization Specialist - Medical Coder Job Description","","Western New York BloodCare seeks a Prior Authorization Specialist/Medical Coder to obtain payer-specific prior authorizations and accurately code laboratory and clinical claims. The role verifies patient insurance eligibility and out-of-pocket and prescription coverage, contacts insurers for required approvals, assigns correct CPT/ICD codes aligned with provider documentation, and submits clean claims. It also monitors accounts receivable, correcting denied claims, while ensuring timely payments. 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Our mission is to provide superior outpatient care and support to patients with bleeding disorders.  \nJob Description  \nWestern New York BloodCare is seeking a Prior Authorization Specialist/Medical Coder to join our team. This position will be responsible for obtaining prior authorizations and for appropriately coding our laboratory and clinical claims. The ideal candidate will have a strong understanding of the insurance industry.  \nEssential Duties:  \n• Serves as subject matter expert in the area of insurance prior authorization processes and coding for services rendered by our providers.  \n• Verifies insurance coverage for all patients including eligibility, out‐of‐pocket costs and prescription coverage.  \n• Contacts insurers to obtain payer specific prior authorization for all clinical, laboratory and pharmacy services.  \n• Identifies accurate CPT/ICD codes for clinical and laboratory services and ensures billing is supported by the provider's documentation.  \n• Submits clean claims to payers for clinical and laboratory services.  \n• Monitors Accounts Receivable accounts to ensure timely payment. This may include correction of denied claims and other follow up as needed.  \nExperience:  \n• Minimum of 2 years experience in the medical field  \n• Previous medical coding experience ‐ Certification preferred  \n• Prior authorization, case management or utilization review experience  \n• Knowledge of CPT codes, ICD‐9 and ICD‐10 codes  \n• Working knowledge of third party payer statutory legislation and regulations  \n• Ability to meet deadlines  \n• Minimum of Associates degree in related field preferred  \n• Attention to detail  \n• Strong interpersonal communication and presentation skills  \n• Experience with Microsoft Office Suite (Excel, Word, Outlook) and related software programs  \n• Salary will be based on experience and Medical Coding Certification status Job Type: Full‐time  \nSalary: $20.00 ‐ $26.00 per hour Benefits:  \n• Dental insurance  \n• Disability insurance  \n• Employee assistance program  \n• Flexible spending account  \n• Health insurance  \n• Life insurance  \n• Paid time off  \n• Vision insurance  \nSchedule:  \n• Day shift  \n• Monday to Friday Work Location: In person","cbCaiuLSkDMKbfDr","https://ap.wps.com/l/cbCaiuLSkDMKbfDr","pdf",169913,"English","# About Us\n# Job Description\n## Essential Duties\n# Experience Requirements\n# Salary and Benefits\n# Schedule and Work Location","[{\"question\":\"What are the main responsibilities of the Prior Authorization Specialist/Medical Coder?\",\"answer\":\"The role obtains payer-specific prior authorizations, verifies insurance coverage and patient eligibility, assigns accurate CPT/ICD codes supported by provider documentation, and submits clean laboratory and clinical claims.\"},{\"question\":\"What experience and knowledge are required for the position?\",\"answer\":\"The position requires a minimum of 2 years in the medical field, prior medical coding experience (certification preferred), prior authorization or utilization review experience, and working knowledge of CPT codes and ICD-9/ICD-10.\"},{\"question\":\"How does the position handle denied or unpaid claims?\",\"answer\":\"It monitors accounts receivable to ensure timely payment and may include correcting denied claims and other follow-up as needed.\"}]","Prior-Authorization Specialist - Medical Coder Job Description | PDF",1789359781]