Reimbursement Authorization Specialist
6 days ago
We are seeking a highly skilled Reimbursement Authorization Specialist to join our team at Ajinomoto Cambrooke. As a key member of our Revenue Cycle Department, you will play a critical role in ensuring the accuracy of all necessary documentation and coordination with healthcare professionals, agencies, and payers to facilitate patient access to products while maintaining compliance and providing top-notch customer service.
Key Responsibilities- Manage and ensure the accuracy of all necessary documentation and coordination with healthcare professionals, agencies, and payers to facilitate patient access to products.
- Contact healthcare professionals, state agencies, and payers for clinical documents, eligibility, benefits, prior authorization, single case agreements, and other items to ensure payment.
- Assist in uploading current documents and populating required fields in Sales Force.
- Continue to work and maintain such documents so effective dates are always current.
- Ensure all incoming requests are worked and responded to timely, following the guidelines set forth within Revenue Cycle Department.
- Coordinate with other contracted Durable Medical Equipment companies and/or Pharmacies to ensure that patient(s) and their families can obtain the formula and medical foods they require.
- Provides assistance and guidance for patient(s) and their families working through eligibility, benefit verification, and prior authorization process with payers.
- Provides excellent customer service resolving inquiries & issues in a timely, professional, and caring manner with compassion and drive to ensure patient(s) and their families receive optimal coverage.
- Minimum High School Diploma or equivalent.
- Multiple years work experience in medical billing, eligibility, authorization, and interaction with payers.
- Understanding of HCPCs and ICD10 coding.
- Knowledge of third-party rules and regulations to include contracts and agreements.
- Proficiency in Microsoft Office; Excel, Word, Teams, etc.
- Ability to multi-task, with attention to detail to ensure accuracy.
- Able to prioritize work, anticipate department needs, plan accordingly, and handle many interruptions with ease.
- Strong written and oral communications skills required to provide excellent customer service and/or Revenue Cycle updates.
- Contribution to health insurance.
- Wellness and mental health benefits.
- Employee life insurance.
- Discounts to selected external services (dry cleaning, technology, etc.).
- Expense reimbursement (milage, rentals, etc.).
- Laptop, Tablet, Company Cell Phone.
- 3 Weeks Paid Time Off.
- Short and Long Term Disability coverage.
- Fitness reimbursement.
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