Prior Authorization Specialist
4 weeks ago
About Us:
For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.
Position: Prior Authorization Specialist
Location: Norwood Office
Department: Billing
Schedule: Hybrid work-from-home option post-training with flexible hours
Key Benefits for Full-Time Employees:
- Competitive pay based on experience, minimum $18
- 401k with Profit Sharing and 4% Company Match
- Comprehensive Medical, Dental, and Vision insurance
- Long-Term and Short-Term Disability Insurance
- Company Paid Life Insurance
- Paid Holidays
- Over three weeks of Paid Time Off
- Continuing Education Reimbursement
- Uniform Allowance
- Free Parking
Responsibilities:
As a Prior Authorization Specialist at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include:
- Streamline pre-certification, authorization, and referral processes, ensuring compliance with insurance requirements
- Coordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determination
- Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients
- Ensure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin procedures
- Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet
- Initiate patient education on available assistance programs
Background and Experience:
- 1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice
- Experience with an Electronic Medical Record (EMR) and practice management system
- Knowledge of Medicare/Medicaid and major insurance carrier's guidelines
- Working knowledge of ICD-9-10 medical coding and billing and medical terminology
- Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors
If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice.
Equal Opportunity/Drug-Free Workplace:
Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace.
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