CRT Authorizations Specialist
About The Position
People with a disability are often held back from pursuing their dreams by worn or ill-fitted technology that makes it impossible for them to live life to the fullest. Poor service providers or financial obstacles can keep the best solutions out of reach, causing stress, worry, delay, and even decreased function. Action Seating & Mobility keeps people moving with the latest technology, personally fit to meet their physical and financial needs with understanding and compassion. When you work for Action, you will be empowering individuals with disabilities to access their world. We are currently seeking outstanding candidates to help us Keep our Clients Moving! As a Authorizations Specialist , you will work alongside other medical professionals to provide the most appropriate, best-fitting mobility equipment and ensure we are appropriately reimbursed for our services.
Requirements
- High school diploma/GED required.
- 2+ years of experience submitting and receiving authorizations from Medicaid required
- 3+ years of Durable Medical Equipment billing required to include Medicaid.
- Knowledge of medical terminology, Medicare LCD, HCPCS, and diagnosis codes required.
- Strong written and oral communication skills including strong phone acumen to effectively communicate across diverse populations including patients, parents/caretakers and healthcare professionals.
- Strong proficiency in using computer and computer applications, including Adobe Acrobat, creating/editing Word documents and Excel spreadsheets, conducting research using the internet, using templates, working in a company-created database, and using Outlook (email/calendar functions).
- Ability to learn and retain the specific criteria and requirements for different insurance plans.
- The main tasks for this position are working with multiple parties to facilitate error-free claims submission by validating HCPCS coding, medical documentation, and knowing Medicare, Medicaid, and third-party insurance coverage policies; working aging to follow up and collect payment.
Nice To Haves
- Preference will be given to candidates who have verifiable experience submitting authorizations for Complex Rehab Technology
- Preference will be given to candidates who have verifiable experience submitting claims to Medicare & Medicaid for Complex Rehab Technology
Responsibilities
- Submit medical documentation for authorizations with Medicaid, Medicaid Managed Care Organizations (MMCOs), Private and Third-Party Payers
- Follow up on authorizations and submit appeals
- Knowing CRT HCPCs codes and reimbursement policies for those codes for varying payers
- Working with TEAM members to educate and facilitate obtaining medical documentation per reimbursement policies
- Price & Code encounters in Atlas to create paperwork
- Compile documentation to be submitted from claims and appeals
- Learn to process insurance claims for CRT, and be back up to the Billing TEAM Lead
- Learn to read EOBs/ERNs and understand denial reason codes
- Posting payments and working with payment processing to identify improper payment
- Working aging to pursue payment for open balances to ensure proper payment
- Enhances company reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
- Attends regularly scheduled TEAM Meetings
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
