Rev Cycle Specialist (Prior Authorizations)

Prism Vision Group•Berkeley Heights, NJ

14d•$21 - $44•Onsite

About The Position

The Revenue Cycle Specialist (Prior-Authorization) reports to the Senior Revenue Cycle Manager and is responsible for a variety of duties including, but not limited to, reviewing patient information, workflow reporting, prior-authorization submission, and troubleshooting with all insurance carriers. The Revenue Cycle Specialist is responsible for completing prior-authorizations with accuracy and timeliness.

Requirements

Education: High School Diploma or equivalent; Bachelor’s degree preferred.
Experience: 1+ years’ experience in an administrative role; medical billing experience within Ophthalmology preferred but not required.
Working knowledge of prior-authorization process
Experience with Medicare, insurances, claims, appeals
Knowledge of CPT, ICD-9 and/or ICD-10 codes a plus
Proven customer service skills
Able to work in a high volume/fast-paced environment
Excellent written and verbal communication skills
Outstanding attention to detail and excellent time management skills
Outstanding typing and computer skills with billing software, Microsoft Word and Microsoft Excel
Ability to work with sensitive and confidential information

Nice To Haves

medical billing experience within Ophthalmology preferred but not required.
Knowledge of CPT, ICD-9 and/or ICD-10 codes a plus

Responsibilities

Identifies all appointments and procedures that require prior-authorization by monitoring system reports
Reviews patient diagnoses and medical notes/laboratory reports required for prior-authorizations submissions
Accountable for knowledge of updated drug and procedure prior-authorization requirements, relating to all commercial insurance carriers
Communicates with Insurance carriers by phone for cases of urgency, down systems, research/clarifications or troubleshooting
Independently maintains and updates multiple reports on all upcoming patient appointments and prior-authorizations
Maintains patient confidentiality
Utilizes insurance portals to submit prior-authorizations
Troubleshoots prior-authorization cases for insurances
Manages a high-volume demand for prior-authorizations with accuracy
Attends and participates in NJ Retina / or payer meetings/seminars as needed
Maintains open, positive cordial, team-oriented lines of communications with managers and staff members
Contributes to the Business office team thought, positive attitude, respectful interaction, innovative ideas and efficiently
Other duties as assigned