Prior Authorizations Specialist

1 month ago

Friendswood, United States Addison Group Full time
Job DescriptionJob Description

Job Title: Prior Authorization Specialist

Location (city, state): Friendswood, Texas

Industry: Healthcare

Pay: $45,000, with bonuses.


About Our Client: Addison Group is recruiting on behalf of our client, a leader in the healthcare industry, dedicated to providing excellent patient services and support.


Job Description: We are looking for a Prior Authorization Specialist who will handle the submission and follow-up of prior authorizations to ensure timely and accurate processing.


Key Responsibilities:

  • Submit and track prior authorization requests.
  • Obtain authorizations through payer websites or by phone, and regularly follow up on pending cases.
  • Communicate with referring physicians for additional information as required.
  • Initiate reconsiderations for denied authorizations.
  • Review specific test coverage eligibility and create custom reconsideration letters.
  • Assign insurance plans and perform eligibility verification for new patient accounts in the billing system.
  • Manage a high-volume, time-sensitive workload while multitasking effectively.
  • Identify and report payer trends or issues to the Billing Supervisor and Billing Manager.
  • Collaborate with teammates to set daily priorities and meet turnaround time standards.


Qualifications:

  • Preferred minimum of two years of experience in health insurance eligibility and prior authorization or equivalent.
  • Experience working with patients, providers, and insurance plans to complete the pre-billing process or equivalent.
  • Experience researching and using payer websites with attention to detail.
  • Understanding of procedure authorization and its impact on the revenue cycle.
  • Proficient in Microsoft Excel, Word, and Outlook.
  • Ability to compile and provide documentation or verbal clinical review to substantiate medical necessity for procedures.
  • Good typing speed with 90% accuracy.
  • Excellent attention to detail.
  • Strong communication skills, both verbal and written.
  • Self-motivated and able to work independently in a remote environment.
  • Team-oriented with a positive attitude and willingness to assist others.
  • Alignment with the mission, vision, and core values of the organization.
  • Minimum 2-year degree preferred and/or some college preferred.
  • High School Diploma or equivalent required.


Perks:

  • Recognized as a Top Workplace USA Award winner for 2023.
  • Competitive annual salary with bonus potential.
  • 20 accrued PTO days annually.
  • 10 paid holidays.
  • 6% 401k match.
  • Company-paid HSA contribution with HDHP option.
  • Company stock grant upon hire.
  • Four healthcare plan options with low premiums ($30-$100 per month for the entire family).
  • 20% bonus of yearly salary, with potential earnings up to $9k annually, paid quarterly.


Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.


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