Prior Authorization Specialist

4 weeks ago


Pasadena, United States California Cardiovascular Care Full time

Applicant must be available to work 30 hours per week in person at the Pasadena office but may occasionally have to go to the Glendora office. You must have **one** years of experience in both billing and authorizations. Must be able to work as a team with three other billers, meet each week and be accountable for progress.
- Must accurately complete Eligibility Verification, Authorization requests/follow-up, and correct insurance data entry to ensure timely payment reimbursement.
- May have to occationally go to Glendora office but the job is based in Pasadena.
- Responsible for processing and verifying insurance requests accurately, in a timely manner.
- Responsible for adding correct insurance information.
- Communicating effectively with various Health Plans and Insurance companies.
- Communicating effectively, providing courtesy and clear communication with external and internal staff.
- Excellent Customer Service Skills - Occasional Patient communication.
- Assisting with re-verification.
- Weekly reporting of stats.
- Demonstrate honesty and integrity in everyday activities.
- Experience in detecting eligibility discrepancies.
- Good communication and phone skills.
- Generates revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts.
- Collects delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when payment lapses occur.
- Maintains Medicare bad-debt cost report by tracking billings, monitoring collections, and compiling information.
- Maintains work operations by following policies and procedures and reporting compliance issues.
- Maintains quality results by following standards.
- Protects clinic’s/hospital’s value by keeping collection information confidential.
- Updates job knowledge by participating in educational opportunities.
- Serves and protects the clinical community by adhering to professional standards, hospital or clinic policies and procedures, federal, state, and local requirements and standards.
- Enhances billing department and practice reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.

Education, Experience, and Licensing Requirements:

- High school diploma
- University/college degree or experience in medical records, claims, or billing areas is an asset.
- Minimum 1 years of previous medical office experience preferred

Please attach your resume with your current address and phone. The first interview will be on zoom or facetime.

Pay: $17.00 - $22.00 per hour

**Benefits**:

- Paid time off

Weekly day range:

- Monday to Friday

**Experience**:

- Medical billing: 1 year (required)
- Cardiology office: 1 year (preferred)
- Authorization: 1 year (required)

Work Location: In person



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