Prior Authorization Specialist
About The Position
DeCoach Recovery is a leading addiction treatment center located in Sharonville, OH, dedicated to providing compassionate care and effective solutions for individuals battling addiction. We are seeking a detail-oriented and experienced Prior Authorization Specialist to join our team. In this vital role, you will manage the authorization process for various medical services, ensuring timely approval from insurance providers. Your expertise will help streamline patient care, reduce delays, and enhance overall satisfaction by navigating complex managed care protocols with precision and professionalism.
Requirements
- Proven experience in managed care or medical office environments, preferably with prior authorization responsibilities
- Strong knowledge of medical terminology, medical records management, and medical coding (CPT, ICD-9, ICD-10)
- Familiarity with insurance verification processes and healthcare billing procedures
- Experience working in dental or medical offices is highly desirable
- Excellent organizational skills with attention to detail and accuracy
- Ability to navigate HIPAA regulations diligently to protect patient confidentiality
- Office experience demonstrating proficiency with electronic health records (EHR) systems or similar software
Responsibilities
- Review and prepare prior authorization requests for medical procedures, medications, and treatments
- Verify insurance coverage and eligibility through insurance verification processes
- Accurately code procedures using CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems
- Maintain comprehensive medical records and documentation in compliance with HIPAA regulations
- Communicate effectively with healthcare providers, insurance companies, and patients to facilitate authorization approvals
- Track and follow up on pending authorizations to ensure timely responses
- Stay current with changes in managed care policies, coding standards, and regulatory requirements
Benefits
- Competitive salary based on experience.
- Medical, Dental, & Vision Heath Insurance
- Company Paid Life Insurance
- Affiliated with the STAR program, assist employees in paying off student loans
- Tuition Reimbursement program
- Paid Time-Off
- 6 paid Holidays off
- Opportunities for Advancement
- Yearly Merit Raises
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
