Healthcare Prior Authorizations Specialist - REMOTE

Quadris Team LLC-posted 3 days ago

Full-time • Entry Level

Remote

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Quadris Team, LLC - A Revenue Cycle Management Group, is searching for that dynamic person to join us, working with our highly skilled Authorizations Team to fill the role of Prior Authorization Specialist for General Surgery. We are a 100% remote team supporting our clients across the United States! See us at www.quadristeam.com. The ideal applicant will reside in Pacific Standard Time or Mountain Standard Time Job Focus: Responsible for obtaining prior authorizations for facility services based on assigned specialty or clinic area. This position will secure the prior authorization and notify the rendering party in the timeliest manner possible so patients can receive necessary care and services with the least delay. Responsible for answering patient calls, providing outgoing patient communication regarding financial obligations and authorization status. Responsible for patient estimation, benefit education, and payment processing.

Accurately, efficiently and timely work prior authorization requests-referrals
Receive request for prior authorizations through the electronic health record (EHR) and/or via phone, email or fax and ensure that they are properly and closely tracked and monitored
Process referrals and submit medical records to insurance carriers to expedite prior authorization processes
Manage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriate
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
Review accuracy and completeness of information requested and ensure that all supporting documents are present
Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial
Prioritize the incoming authorizations by level of urgency and date of service
Secure patient information in accordance with client policy/procedures
Other duties as assigned
Monitors WQs, and resolves accounts in a timely manner
Stay up to date on insurance company policies and procedures related to prior authorizations

Maintains compliance with regulations and laws applicable to job
Professional level of communication with video, phone, and email
Ability to effectively prioritize the work to meet deadlines and expectations
Meets the quality and productivity measures as outlined by Quadris
Brings positive energy to work
Uses critical thinking skills
Being present and focused on assigned tasks and eliminates distractions
Being a self-starter
Ability to work independently and within a team atmosphere
High School diploma or equivalent
1+ years of experience working in health care, medical billing, with a focus on prior authorization preferred
Knowledge of insurance process and medical terminology preferred
Honors and sets high expectations for patient confidentiality and customer service in accordance with Quadris Team policies and procedures and HIPAA requirements
Advanced level of industry standard electronic medical record content
Must have professional level skills in MS products such as Excel, Word, Power Point.
Proficient application of business/office standard processes and technical applications

PACS (Prior Authorization Certified Specialist) Certification preferred

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Healthcare Prior Authorizations Specialist - REMOTE

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