Prior Authorization Specialist

Join Our Team!

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC). MSC is a 13-time recipient of the NorthCoast 99 Award as a Top Workplace to work! MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US. In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!

We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!

Competitive Pay

Advancement Opportunities

Medical, Dental & Vision Insurance

HSA Account w/Company Contribution

Pet Insurance

Company provided Life and AD&D insurance

Short-Term and Long-Term Disability

Tuition Reimbursement Program

Employee Assistance Program (EAP)

Employee Referral Bonus Program

Social Recognition Program

Employee Engagement Opportunities

CALM App

401k (with a matching program) / Roth IRA

Company Discounts

Payactiv/On-Demand Pay

Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

General

As part of the PAR team, participates in monitoring and improving processes relative to the quality, appropriateness, and timeliness of the reimbursement information requirements of our order processing activities.

Responsibilities and Duties

Initiates renewal authorization requests with insurance companies and government payers.

Monitors outstanding renewal authorization requests and initiates follow up of authorizations in a timely manner.

Responsible for working all outstanding held revenue related to prior authorizations for insurances assigned.

Handles all claim denials due to missing prior authorization for insurances assigned.

Maintains accurate and complete records concerning billing activity.

Manages phone calls related to prior authorizations.

Training related to PAR processes.

Processes insurance changes when prior authorizations are needed.

Communicates obstacles or challenges to PAR Supervisor/Manager that may lead to inaccurate or untimely resubmissions of claims.

Serves as back up for prior authorization team tier 1.

Other duties as assigned.

Qualifications

Education: Graduate of an accredited high school or GED equivalence.

Experience/Knowledge/Skills/Physical Requirements:

Minimum 3 years of revenue cycle experience in healthcare

Ability to multi-task in a fast-paced environment

Detail and team oriented

Effective communication (verbal and written) and organizational skills

Proven computer proficiency, the use of multiple applications simultaneously

Previous experience in prior authorizations and insurance verification is required

Knowledge of the HME/DME industry is preferred