Prior Authorization Specialist

Company: Riverhills Neuroscience
Location: Cincinnati
Posted on: May 9, 2024

Job Description:

*About Us:*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.*Position:* Prior Authorization Specialist*Location:* Norwood Office*Department*: Billing*Schedule: *Hybrid work-from-home option post-training with flexible hours*Key Benefits for Full-Time Employees:** Competitive pay based on experience, minimum $18* 401k 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 Off* Continuing 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* 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 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.#IND3Job Type: Full-timePay: From $18.00 per hourBenefits:* 401(k)* 401(k) matching* Dental insurance* Disability insurance* Employee assistance program* Employee discount* Flexible schedule* Flexible spending account* Health insurance* Health savings account* Life insurance* Paid time off* Referral program* Vision insuranceWork Location: Hybrid remote in Cincinnati, OH 45212by Jobble

Keywords: Riverhills Neuroscience, Covington , Prior Authorization Specialist, Other , Cincinnati, Kentucky