Revenue Cycle Authorizations Specialist

Accra • Minnetonka, MN

14d • Remote

About The Position

The Revenue Cycle Authorizations Specialist I obtains and monitors initial and renewal authorizations in a timely manner. The role works with internal teams, county workers, and case managers to ensure accurate client information is included on agreements and tracked. The ideal candidate is familiar with prior authorization processes or has experience billing claims with Minnesota Medical Assistance (MA) Electronic Remittances, and has working knowledge of Minnesota PMAP and its service agreement types.

The specialist tracks, updates, communicates, and archives authorizations; checks eligibility; supports documentation requests; collaborates with billing teams to resolve pending claims; researches service agreement issues; and responds to inquiries about coverage, pre-authorizations, forms, and benefits. The role also uses databases and software systems for revenue cycle activities, including eligibility, authorizations, account updates, claims, and denials, and may take on additional revenue cycle projects and duties as needed.

Requirements

• Associate degree or similar education and experience.
• Proven knowledge of and experience with Revenue Cycle or Practice Management software.
• Proficiency with Microsoft Office, including Word and Excel.
• Proficiency with Microsoft Outlook and Teams.
• Understanding of basic HIPAA regulations.
• General knowledge of CPT and ICD-10 coding principles and guidelines as related to authorizations.
• Excellent interpersonal and communication skills, with the ability to collaborate effectively.
• Strong organizational skills and attention to detail.
• Ability to work in a fast-paced, virtual business environment.
• Ability to meet metrics and key performance indicators applicable to general revenue cycle management benchmarks.
• Ability to meet Accra remote work experience requirements.
• Ability to work independently at times with little supervision.

Nice To Haves

• CFSS, PCA, 245D, and/or Home Health Care waiver billing experience.
• Familiarity with MNITS, Availity, and clearinghouse usage.
• Previous remote work experience.
• Familiarity with prior authorization processes or experience billing claims with Minnesota Medical Assistance (MA) Electronic Remittances.
• Working knowledge of the Minnesota PMAP program and its service agreement types.

Responsibilities

• Monitor, track, communicate, and archive authorizations using designated software systems and reports.
• Track current authorizations and update them before service agreement expiration dates.
• Identify documentation needed for service agreement requests and work with intake and case service teams to obtain current, correct authorizations.
• Check eligibility to determine current client status.
• Use Outlook to monitor and track incoming Service Agreements and distribute them according to protocols.
• Collaborate with program and revenue cycle billing team members to review and resolve pending claims for timely reimbursement.
• Research and resolve service agreement issues and report missing authorizations.
• Identify and report overspend in utilization where apparent.
• Provide customer service and timely responses to internal and external questions about coverage, pre-authorizations, forms, and benefits.
• Use databases and software systems to input, retrieve, update, and monitor revenue cycle activities, including eligibility, discharge, authorizations, patient accounts, claims, and denials.
• Perform additional revenue cycle projects and job duties as needed.

Benefits

• Schedules designed to support work/life balance.
• Generous PTO, including an additional paid self-care day and a separate paid community volunteering day.
• Free wellbeing programs.
• HSA and FSA plans.
• 401(k) retirement plan.
• Medical, dental, and vision coverage for full-time employees.
• Training and growth opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree