Prior Authorizations/Medical Assistant

Prior Authorization & Insurance Coordination:

• Verify insurance eligibility, benefits, and payer requirements for sleep-related services
• Obtain and manage prior authorizations/pre-certifications for:
  • Home Sleep Apnea Testing (HSAT)
  • In-Lab Sleep Studies (Polysomnography)
  • CPAP/BiPAP titration studies
  • Durable Medical Equipment (DME), PAP devices, and supplies
  • Follow-up visits and specialty referrals as needed
• Submit medical records and clinical documentation to insurance carriers
• Monitor authorization approvals, denials, renewals, and expiration dates
• Coordinate peer-to-peer reviews, appeals, and denial resolutions
• Communicate authorization status and financial responsibility to patients

Medical Assistant Duties:

• Room patients and obtain vital signs, medical history, medication reconciliation, and sleep-related symptom updates
• Prepare patients for provider visits, consultations, and follow-up appointments
• Assist providers with examinations, procedures, and patient education
• Educate patients on sleep study preparation, CPAP/BiPAP compliance, and treatment plans
• Process prescription refills, DME orders, and provider documentation
• Maintain exam rooms, supplies, and clinical equipment
• Support scheduling and coordination of sleep studies and follow-up appointments