Prior Authorization Specialist Tier 2

Medical Service Company•Cleveland, OH

4d•Hybrid

About The Position

MSC is hiring a full-time hybrid Prior Authorization Specialist Tier 2. The position is part of the PAR team and participates in monitoring and improving processes related to the quality, appropriateness, and timeliness of reimbursement information required for order processing. The employee works in the office on Tuesdays, Wednesdays, and Thursdays, with remote work on the other days. The position reports to the Manager, PAR.

Requirements

Graduate of an accredited high school or GED equivalent.
At least 3 years of revenue cycle experience in healthcare.
Ability to multitask in a fast-paced environment.
Detail-oriented and team-oriented.
Effective verbal and written communication and organizational skills.
Proven computer proficiency, including using multiple applications simultaneously.
Previous experience in prior authorizations and insurance verification is required.

Nice To Haves

Knowledge of the HME/DME industry.

Responsibilities

Initiate renewal authorization requests with insurance companies and government payers.
Monitor outstanding renewal authorization requests and follow up in a timely manner.
Work outstanding held revenue related to prior authorizations for assigned insurers.
Handle claim denials due to missing prior authorization for assigned insurers.
Maintain accurate and complete records concerning billing activity.
Manage phone calls related to prior authorizations.
Provide training related to PAR processes.
Process insurance changes when prior authorizations are needed.
Communicate obstacles or challenges to the PAR Supervisor or Manager that may lead to inaccurate or untimely claim resubmissions.
Serve as backup for the Tier 1 prior authorization team.
Perform other duties as assigned.