Prior Authorization Specialist

1 day ago

Cincinnati, Ohio, United States DeCoach Rehabilition Center Full time

DeCoach Recovery Centre, a local leader in addiction recovery, is seeking an experienced prior authorization specialist to work at our corporate headquaters in Sharonville, OH. This role is critical in ensuring the financial health of our organization.

Job Overview: As a Revenue Cycle Specialist / Prior Authorization Specialist, you will be responsible for overseeing the prior authorization process, including billing, collections, and insurance verification. You will work closely with the finance and administrative teams to ensure accurate and timely processing of patient accounts and maximize revenue for the organization.

Key Responsibilities:

  • Manage the end-to-end revenue cycle process, including charge entry, claims submission, payment posting, and collections.
  • Review and verify accuracy of patient demographic and insurance information.
  • Ensure proper coding of diagnoses and procedures according to industry standards and compliance requirements.
  • Investigate and resolve any billing discrepancies or denials from insurance companies.
  • Follow up on unpaid claims and delinquent accounts to optimize collections.
  • Collaborate with clinical and administrative staff to streamline revenue cycle workflows and improve efficiency.
  • Stay updated on changes in healthcare regulations and insurance policies affecting revenue cycle operations.
  • Analyze data related to revenue cycle performance.

Qualifications:

  • Associates degree in Healthcare Administration, Finance, Business, or related field preferred.
  • Proven experience (2+ years) working in healthcare revenue cycle management or medical billing.
  • Strong knowledge of medical billing practices, including CPT and ICD-10 coding.
  • Familiarity with insurance verification and prior authorization processes.
  • Proficiency in using healthcare billing and accounting software
  • Excellent attention to detail and organizational skills.
  • Strong analytical and problem-solving abilities.
  • Ability to communicate effectively with patients, insurance companies, and internal stakeholders.
  • Understanding of HIPAA regulations and patient confidentiality.

Benefits:

  • Competitive salary based on experience.
  • Medical, Dental, & Vision Heath Insurance
  • Company Paid Life Insurance
  • Affiliated with the STAR program, assist employees in paying off student loans
  • Tuition Reimbursement program
  • Paid Time-Off
  • 6 paid Holidays off

Join our dedicated team at DeCoach Recovery and contribute to our mission of providing quality addiction treatment services while ensuring financial sustainability through effective revenue cycle management. If you have the required skills and experience, we encourage you to apply and become part of our compassionate and dynamic team.

8-4:30pm

  • Prior Authorization Specialist

    5 days ago

    Cincinnati, Ohio, United States DOCS Dermatology Group Full time

    Prior Authorization SpecialistCompany Overview At DOCS Dermatology Group, we are not just one of the largest dermatology practices in the nation; we are a dedicated community passionate about skin health With more than 200 providers across 20 practice brands and 100+ locations in 10 states, we've been transforming the lives of our patients for more than 40...

  • Technical Support Product Specialist

    2 weeks ago

    Cincinnati, Ohio, United States London Computer Systems Full time $40,000 - $80,000 per year

    About the CompanyLCS - London Computer Systems is a software development company located in Northern Cincinnati, Ohio. The main software we have developed is called, Rent Manager Property Management Software. Since 2012, LCS has been consistently recognized as a Top Workplace with a supportive culture that fosters collaboration and authenticity. We also love...

  • Sales Specialist

    7 days ago

    Cincinnati, Ohio, United States VITL Power Full time

    Company DescriptionVitl Power is a subsidiary of Freedom Forever which is a leading residential solar installation company that partners with solar sales companies to empower their success. Established in 2011, we provide premium services with a 25-year production guarantee, delivering peace of mind to homeowners investing in solar energy. Headquartered in...

  • Retention Specialist

    2 weeks ago

    Cincinnati, Ohio, United States AnewHealth Full time $30,000 - $50,000 per year

    AnewHealth is one of the nation's leading pharmacy care management companies that specializes in caring for people with the most complex, chronic needs—wherever they call home. We enable better outcomes for patients and the healthcare organizations who support them. Established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare, we...

  • Client Support Specialist

    1 week ago

    Cincinnati, Ohio, United States Central Clinic Behavioral Health Full time

    Join our Mission-Driven, 5-time Top Workplace Award Winning OrganizationPOSITION: Clerical Support SpecialistLOCATION: 2208 Reading Road, Cincinnati, OH 45202PROGRAM/DEPARTMENT: FAIR & HOPE/Central ConnectionEMPLOYMENT TYPE: Full Time; 40 Hours Per Week; Monday - FridayABOUT USAt Central Clinic Behavioral Health, our mission is to inspire meaningful change...

  • Credentialing Specialist

    3 days ago

    Cincinnati, Ohio, United States CAREX BEHAVIORAL HEALTH SERVICES Full time

    Benefits:Dental insurance Health insurance Paid time off Vision insurance Position Title: Credentialing Specialist Department: Revenue Cycle Management (RCM Reports To: Clinical Director FLSA Status: Exempt Employment Type: Full-Time     Job Level: 7 Wage Type: Hourly  Job Summary The Credentialing Specialist supports the Revenue...

  • Outcomes Specialist

    2 days ago

    Cincinnati, Ohio, United States Cincinnati Animal CARE Full time

    Outcomes SpecialistJob Type: Full-timePay: $15/ hourWork Location: On siteReports to Outcomes ManagerCompany OverviewCincinnati Animal CARE (CAC) is a dynamic and progressive humane society in contract with Hamilton County to deliver exceptional animal services to our community. We enforce animal laws and prioritize public safety while striving to be a...

  • Post Closing Specialist

    7 days ago

    Cincinnati, Ohio, United States Coforge Full time

    Role: Post Closing SpecialistJob Location: 5001 Kingsley Drive, Cincinnati, Ohio, 45227Mod Of Hire: Full TimeGENERAL FUNCTION:The Post Closing Correction Specialist is responsible for the determination of requirements, review and completion of all due diligence associated with the Post Closing of residential mortgage loans and subsequent document follow-up...

  • Communications Specialist

    24 hours ago

    Cincinnati, Ohio, United States Raymond Storage Concepts, Inc. Full time

    Pay: $90,00 - $95,000Raymond Storage Concepts is a leading provider of customized material handling solutions, dedicated to warehouse and fleet optimization. Covering Ohio, Kentucky, Southeast Indiana and West Virginia, Raymond Storage Concepts is an authorized sales and service center for Raymond Corporation, a global leader in materials handling...

  • Life Skills Specialist

    24 hours ago

    Cincinnati, Ohio, United States NewPath Child & Family Solutions Full time

    Welcome Are you ready to begin a NewPath? At NewPath, we do more to make a difference -more for each child, each client, and our community. Our dedicated team does what it takes, day and night, to get to the heart of every case and deliver the best care. Backed by a full breadth of services, we cater to each individual and answer to every need. We reach more...