Reimbursement, Pre-Billing Prior Authorization Specialist (FWD)
About The Position
This individual is responsible for all aspects of the prior authorization process, including collecting necessary documents, contacting providers and patients for additional information or assistance, and completing required prior authorizations. This position also works closely with the Benefits Verification Team to validate patients' insurance plans. The role will spend the majority of its time ensuring all pertinent medical documentation is accurate and complete prior to submission, maintaining a strong understanding of insurance company requirements and authorization/referral guidelines, submitting and following up on assigned authorization requests, obtaining authorizations via payer websites or by phone, and regularly following up on pending cases, as well as contacting referring physician offices for additional information when needed.
Requirements
- High school diploma or equivalent work experience required.
- Minimum, 1 year of experience in this role for same company.
- Typing speed of 35 or more words per minute, with 90% or greater accuracy.
- Experience researching and utilizing payor websites or equivalent job experience with attention to detail.
- Experience collaborating with multiple teams to achieve goals
Responsibilities
- collecting necessary documents
- contacting providers and patients for additional information or assistance
- completing required prior authorizations
- validating patients' insurance plans
- ensuring all pertinent medical documentation is accurate and complete prior to submission
- maintaining a strong understanding of insurance company requirements and authorization/referral guidelines
- submitting and following up on assigned authorization requests
- obtaining authorizations via payer websites or by phone
- regularly following up on pending cases
- contacting referring physician offices for additional information when needed
Benefits
- Excellent Annual Salary + 20% Bonus Potential
- 20 Accrued PTO Days Annually
- 10 Paid Holidays
- 401K with 100% Company Match up to 6%
- 3 Health Care Plan Options + Company HSA Contribution
- Company Stock Grant Upon Hire
- $75/month reimbursement for internet service
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
