Authorizations/Credentialing Specialist

4 days ago

Van Buren, Arkansas, United States Lumina Behavioral Health Full time

Lumina is a family owned business specializing in revenue cycle management solutions for medical and behavioral health providers. Pay is dependent upon experience.

  • Education: A high school diploma or GED is typically required; an associate's degree is a plus.
  • Experience: Some experience in medical billing, insurance authorization, or a related field is strongly preferred.
  • Skills:
  • Knowledge of medical terminology.
  • Proficiency with basic computer skills
  • Proficiency in Microsoft Office software suite
  • Strong attention to detail.
  • Excellent communication skills.
  • Strong organizational skills for managing multiple requests.

Responsibilities include:

  • Insurance verification: Determine insurance eligibility, benefits, and authorization requirements for services.
  • Request submission: Initiate and complete prior authorization requests for appointments, procedures, and medications.
  • Information gathering: Collect necessary demographic, insurance, and clinical information from patients and providers.
  • Communication: Serve as a liaison between healthcare providers, patients, and insurance companies, clarifying non-covered benefits and explaining processes.
  • Tracking and follow-up: Monitor the status of requests, track all communication attempts, and follow up on denials to gather additional documentation for appeals.
  • Data entry: Accurately enter and update patient and authorization information in the relevant system.
  • Compliance: Adhere to patient confidentiality, HIPAA, and other regulatory requirements.

Job Type: Full-time

Pay: From $11.00 per hour

Benefits:

  • Flexible schedule

Work Location: Hybrid remote in Van Buren, AR 72956

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