Authorization Specialist

2 weeks ago

Princeton, United States Lingraphica Full time
Job DescriptionJob DescriptionCompany Description

Lingraphica is a mission-driven organization who provides speech-generating devices to help improve communication, speech, and quality of life for people with communication impairments.  We look for candidates who enjoy working in a fast-paced, goal-oriented environment, and who share our commitment to helping individuals on their communccation journey.

Job Description

Purpose: The Authorization Specialist’s main function is to secure funding approvals for our customers whether it be from private insurances, State funding, Medicare, or any other type of funding source. This position serves as the liaison between many other teams and provides excellent customer service to employees as well as customers using their knowledge of how insurance verifications, medical policies, and insurance requirements/guidelines work. The Authorization Specialist is also responsible for maintaining accurate records of policies and insurances for employees to view and reference as needed.  

Essential Duties & Responsibilities: 

  • Initiates prior authorizations, pre-determinations, and out-of-network gap exceptions. 
  • Initiates and follows through with authorization appeals. 
  • Follows up on all authorization requests in a timely manner and reports on progress to internal teams. 
  • Applies to and follows up on applications for funding through Government programs.   
  • Negotiates and obtains agreements with insurance companies for individual cases when necessary.  
  • Communicates internally and externally regarding authorizations, appeals, and exceptions. 
  • Assists in eligibility and benefits inquiries when necessary. 
  • Determines the authorization requirements of each health plan and keeps detailed records of the medical policies and requirements. 
  • Maintains accurate and complete documentation of all inquiries. 
  • Proactively communicates with team members regarding identified potential issues and concerns. 
  • Tracks patterns and trends of authorization issues from payers to eliminate future delays in authorization processing. 
  • Exhibits strong problem-solving skills through both verbal and written communications. 
  • Assists reimbursement team in authorization related corrections on rejected or denied claims. 
  • Answers in-bound calls and assists customers. 
  • Exercises the above with discretion and independent judgement. 
  • Performs other duties and works on special projects related to authorization. 
Qualifications

Knowledge, Skills & Abilities 

  • Experience with prior authorizations, pre-determinations, and out-of-network gap exceptions. 
  • Proficient understanding of healthcare provider environment. 
  • Excellent problem-solving skills and attention to detail. 
  • Excellent customer service skills and professionalism. 
  • Ability to comfortably interface with various users across the organization. 
  • Proficiency with MS Outlook, Word, Excel, Adobe.  
  • Knowledge of insurance requirements regarding face-to-face documentation. 

Education & Experience 

  • Bachelor’s Degree or equivalent combination of education and experience 
  • Familiarity with entire revenue cycle and terminology. 
  • Experience with insurance portals such as NaviNet and Availity.  
  • Experience with DME/Home Medical Equipment. 
  • Experience with healthcare claims (e.g. authorization, billing, collections). 


Additional Information

Travel Requirements:

Travel required for the annual company meeting and team off-site, within the continental United States, approximately twice per year.   

Work Environment & Physical Demands: 

Incumbent works from home and is expected to maintain a safe, productive work environment with secure internet access. Must be able to operate a computer with or without a reasonable accommodation. 

Accommodations: 

To perform this job successfully, an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge, skills, and/or ability abilities and physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

To learn more about Lingraphica, visit: www.lingraphica.com

This Organization Participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. 

Este empleador participa en E-Verify y proporcionará al gobierno federal la información de su Formulario I-9 para confirmar que usted está autorizado para trabajar en los EE. UU.

  • Authorization Specialist

    2 weeks ago

    Princeton, United States Lingraphica Full time

    Company Description Lingraphica is a mission-driven organization who provides speech-generating devices to help improve communication, speech, and quality of life for people with communication impairments. We look for candidates who enjoy working in a fast-paced, goal-oriented environment, and who share our commitment to helping individuals on their...

  • Authorization Specialist

    4 weeks ago

    Princeton, New Jersey, United States Lingraphica Full time

    Job Description Purpose: The Authorization Specialist’s main function is to secure funding approvals for our customers whether it be from private insurances, State funding, Medicare, or any other type of funding source. This position serves as the liaison between many other teams and provides excellent customer service to employees as well as customers...

  • GPV Submission Specialist

    4 weeks ago

    Princeton, United States GForce Life Sciences Full time

    Consultant, GPV Case Management Product Specialist, Pharmaceuticals SummaryOur growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. This candidate will collaborate with Regulatory...

  • GPV Submission Specialist

    4 weeks ago

    Princeton, United States GForce Life Sciences Full time

    Consultant, GPV Case Management Product Specialist, Pharmaceuticals SummaryOur growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. This candidate will collaborate with Regulatory...

  • Global PV Submissions Specialist

    4 weeks ago

    Princeton, United States Clinical Resource Network (CRN) Full time

    Our client is looking to fill the role of Global PV Submissions Specialist. This role will be hybrid and based out of the Princeton office.Responsibilities:Manage and document submission of vendor partners/CROs and health authorities, including monitoring and responding submissions inquiries from partners/CROs and health authorities.Preparation of paper...

  • Customer Service Specialist

    3 days ago

    Princeton, United States Rose International Full time

    Date Posted: 05/08/2024 Hiring Organization: Rose International Position Number: 463747 Job Title: Customer Service Specialist Job Location: Princeton, NJ, USA, 08540 Work Model: Onsite Employment Type: Temporary Estimated Duration (In months): 6 Min Hourly Rate ($): 25.00 Max Hourly Rate ($): 29.00 Must Have Skills/Attributes: Customer...

  • Customer Service Specialist

    7 days ago

    Princeton, United States Rose International Full time

    Date Posted: 05/08/2024 Hiring Organization: Rose International Position Number: 463747 Job Title: Customer Service Specialist Job Location: Princeton, NJ, USA, 08540 Work Model: Onsite Employment Type: Temporary Estimated Duration (In months): 6 Min Hourly Rate ($): 25.00 Max Hourly Rate ($): 29.00 Must Have Skills/Attributes: Customer...

  • Customer Service Specialist

    1 day ago

    Princeton, United States Rose International Full time

    Date Posted: 05/08/2024 Hiring Organization: Rose International Position Number: 463747 Job Title: Customer Service Specialist Job Location: Princeton, NJ, USA, 08540 Work Model: Onsite Employment Type: Temporary Estimated Duration (In months): 6 Min Hourly Rate ($): 25.00 Max Hourly Rate ($): 29.00 Must Have Skills/Attributes: Customer...

  • GPV Case Management Product Specialist

    2 days ago

    Princeton, United States GForce Life Sciences Full time

    SummaryOur growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. DescriptionMonitor and manage the ICSR workflow for assigned projects and products to ensure all deadlines are met and...

  • Technical Solutions Specialist

    1 week ago

    Princeton, United States Sharp Decisions Full time

    Title : Systems Support SpecialistLocation : Princeton, NJ - Hybrid - Required to come to PRI office 1x a month, but candidate but me flexible that this requirement could increase based on company decisions.Pay :$37/hr. on W2 OnlyQualificationsJOB DESCRIPTIONKey Responsibilities:Embrace the Core Values, Mission and Vision of the departmentEngage in...

  • Technical Support Specialist

    3 weeks ago

    Princeton, United States Source One Technical Solutions Full time

    Source One is a consulting services company and we’re currently looking for the following individual to work as a consultant with our direct client, a global financial media company in Princeton, NJ Title: Technical Support SpecialistLocation: Princeton Hybrid ( once per month) w-2 hourly: $30.00 - $35.00 Contract Duration: 6 month with potential...

  • Technical Support Specialist

    4 weeks ago

    Princeton, United States Source One Technical Solutions Full time

    Source One is a consulting services company and we’re currently looking for the following individual to work as a consultant with our direct client, a global financial media company in Princeton, NJ Title: Technical Support SpecialistLocation: Princeton Hybrid ( once per month) w-2 hourly: $30.00 - $35.00 Contract Duration: 6 month with potential...

  • GPV Specialist

    10 hours ago

    Princeton Junction, United States GForce Life Sciences Full time

    Summary Our growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. Description Monitor and manage the ICSR workflow for assigned projects and products to ensure all deadlines are met and...

  • RSA Indentity Governance

    3 weeks ago

    Princeton, United States Cloud Security Services Full time

    Job DescriptionJob DescriptionCloud Security Services is looking for an RSA Identity and Governance Lifecycle Specialist.The successful candidate will be able to deliver a solution architecture, detailed design and implementation of the RSA IGL platform, including integrating with endpoints for Identity, Account, Entitlement data collection and provisioning...

  • GPV Specialist

    1 day ago

    Princeton Junction, United States GForce Life Sciences Full time

    SummaryOur growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. DescriptionMonitor and manage the ICSR workflow for assigned projects and products to ensure all deadlines are met and...

  • GPV Specialist

    2 days ago

    Princeton Junction, United States GForce Life Sciences Full time

    SummaryOur growing, mid-sized pharmaceutical client has engaged GForce Life Sciences to provide a GPV Submission Specialist responsible for managing daily operational activities of the Global Submissions Team within Case processing. DescriptionMonitor and manage the ICSR workflow for assigned projects and products to ensure all deadlines are met and...

  • Wildland Firefighter

    3 weeks ago

    Princeton, United States U.S. Fish and Wildlife Service Full time

    Summary This position will be filled under the Office of Personnel Management's Direct Hire Authority and is open to all United States citizens and . nationals. Veteran's preference and traditional rating and ranking of applications do not apply. All qualified applicants will be referred to the hiring manager for consideration for this position. To...

  • GPV Case Management Product Specialist

    1 day ago

    Princeton, United States GForce Life Sciences Full time

    Job DescriptionJob DescriptionResponsibilities Monitor and manage the ICSR workflow for assigned projects and products to ensure all deadlines are met and compliant with safety reporting obligationsSupport PV Management in the oversight of Case Management vendors: triage, troubleshooting problems, escalation as necessaryPerform and/or oversee the collecting,...

  • Access Management Technical Support

    1 week ago

    Princeton, United States Yoh, A Day & Zimmermann Company Full time

    We are looking for strong Access management support specialists to join our team Looking for someone who has a strong background in supporting Identity Access management tools exp such as Okta, PingFederate, MS Azure Key Responsibilities:-Embrace the Core Values, Mission and Vision of the department-Engage in requirements gathering, analyze business...

  • Access Management Technical Support

    1 day ago

    Princeton, United States Yoh, A Day & Zimmermann Company Full time

    We are looking for strong Access management support specialists to join our team Looking for someone who has a strong background in supporting Identity Access management tools exp such as Okta, PingFederate, MS Azure Key Responsibilities: -Embrace the Core Values, Mission and Vision of the department -Engage in requirements gathering, analyze business...