Prior Authorization Specialist

Posted yesterday

riverhills neuroscienceDayton (OH)

Medical Records Specialists Offices of Physicians (except Mental Health Specialists)

SENIORITY

Senior

SALARY

$18-22 per hour

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About the role

Prior Authorization Specialist For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.

Location: Norwood Office

Department: Billing

Schedule: Monday-Friday, 8am-4:30pm, Hybrid, 2 days in office, 3 days remote after full in office training.

Pay: $18-22 per hour

Key Benefits for Full-Time Employees: Competitive pay based on experience, minimum $18401k with Profit Sharing and 4% Company Match Comprehensive Medical, Dental, and Vision insurance Long-Term and Short-Term Disability Insurance Company Paid Life Insurance Paid Holidays Over three weeks of Paid Time OffContinuing Education Reimbursement Uniform Allowance Free Parking

Responsibilities: As a Prior Authorization Specialist at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes.

Your responsibilities include:

Streamline pre-certification, authorization, and referral processes, ensuring compliance with insurance requirements
Coordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determination
Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients
Ensure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin procedures
Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet
Initiate patient education on available assistance programs
Background and Experience:1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice
Pain Management experience is a plus
Experience with an Electronic Medical Record (EMR) and practice management system
Knowledge of Medicare/Medicaid and major insurance carrier's guidelines
Working knowledge of ICD-9-10 medical coding and billing and medical terminology
Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors

If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice. Equal Opportunity/Drug-Free Workplace: Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace.

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