Prior Authorization Specialist

Prior Authorization SpecialistFor 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 OfficeDepartment: BillingSchedule: Monday-Friday, 8am-4:30pm, Hybrid, 2 days in office, 3 days remote after full in office training.Pay: $18-22 per hourKey Benefits for Full-Time Employees:Competitive pay based on experience, minimum $18401k with Profit Sharing and 4% Company MatchComprehensive Medical, Dental, and Vision insuranceLong-Term and Short-Term Disability InsuranceCompany Paid Life InsurancePaid HolidaysOver three weeks of Paid Time OffContinuing Education ReimbursementUniform AllowanceFree ParkingResponsibilities: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 requirementsCoordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determinationFacilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patientsEnsure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin proceduresMonitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheetInitiate patient education on available assistance programsBackground and Experience:1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practicePain Management experience is a plusExperience with an Electronic Medical Record (EMR) and practice management systemKnowledge of Medicare/Medicaid and major insurance carrier's guidelinesWorking knowledge of ICD-9-10 medical coding and billing and medical terminologySuperior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendorsIf 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.