Prior Authorization Specialist
About The Position
Harbor is seeking a Prior Authorization Specialist to join the Toledo team. This position is responsible for timely, effective and efficient revenue cycle tasks to ensure accurate claim submission and receipt of payment. Harbor is a leading provider of mental health and substance use treatment for over 100 years, with 350+ clinical staff serving over 24,000 clients across multiple locations and in the community each year. Services range from counseling, pharmacological management, primary care, psychological testing, case management, substance use treatment, residential services, vocational program, and more!
Requirements
- Certificate in Medical Billing or an associate degree in business, healthcare, accounting, or closely related field required, or may substitute two years related experience in lieu of degree.
- Must have strong attention to detail and be able to communicate effectively with various individuals.
- Competent computer/PC skills using Microsoft Office 365, Excel, and electronic health record systems.
- Must be able to establish daily work priorities and work independently and efficiently to meet deadlines.
- Must be honest, dependable, self-disciplined, organized and be able to work well as a team member.
Nice To Haves
- Demonstrated knowledge and understanding of health/behavioral health billing procedures and eligibilities for third-party providers preferred.
- Previous coding experience in a behavioral healthcare setting preferred.
- Strongly prefer prior experience in customer service and behavioral health setting.
Responsibilities
- Receives incoming questions from clients, payers and/or clinicians regarding client accounts; initiates data submission for any additional information needed, and interprets information back to the client, payer and/or clinician.
- Verifies insurance coverage, co-payment, and coordination of benefits and updates client billing information accordingly.
- Maintains current knowledge regarding public payers, third-party and first-party payment procedures and regulations.
- Reviews, monitors, updates and ensures timely submission and follow-up for payer authorizations.
- Reviews and completes revenue cycle service errors in a timely and efficient manner to ensure timely claim submission.
- Communicates effectively with providers to identify and resolve provider related service errors.
- Effectively utilizes payer portals and other resources to complete assigned tasks including authorizations and service errors.
- Monitors billing fax group to disseminate documents to intended individuals.
- Keeps current with trends and developments related to essential job competencies and demonstrates continued growth.
Benefits
- Medical, dental, and vision coverage
- Retirement plan with company match
- Generous paid time off, sick time, and paid holidays
- Tuition and professional license reimbursement programs
- Clinical supervision hours offered
- Ability to make a difference in your community!
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
101-250 employees
