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Qualification Specialist

2 months ago

Nampa Idaho, United States Norco, Inc Full time
Job Description

Norco, Inc. is seeking a highly skilled professional to fill the position of Qualification Specialist on our Insurance Verification Team.

The successful candidate will be responsible for ensuring that medical documentation is accurate and gathered in an efficient and timely manner for all orders. Key responsibilities include:

  • Having in-depth knowledge of documentation requirements for payers and product categories for which Norco provides services.
  • Understanding insurance company policy manuals, fee schedules, and contracts.
  • Performing insurance verification and gathering medical documentation required to meet specific insurance company guidelines.
  • Submitting and obtaining insurance prior authorizations via various channels.
  • Reviewing documentation to ensure pay coverage criteria is met when prior authorization cannot be obtained from the insurance company.
  • Following up with therapists and physicians when necessary to obtain required documentation.
  • Staying up-to-date with industry updates and Medicare changes.
  • Performing other tasks as assigned or necessary.

This is an exciting opportunity for a detail-oriented and organized individual to join our team and contribute to the success of Norco, Inc.