Job details
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Vacancy TypeRemote
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Pay$20 - $26 an hour
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Job TypeFull-time
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Shift and ScheduleMonday to Friday
Description
Gastro Care Partners is actively seeking a skilled, compassionate, and motivated Infusion Authorization Specialist to join our dynamic, growing team!
The Prior Authorization Specialist is responsible for verification of benefits and eligibility confirmation for patients, as well as obtaining all pre-authorizations and pre-certifications required for infusions and procedures as necessary and appropriate. They work closely with carriers and staff to review, research and complete authorization appeals, rectify rejected claims, and notifying patients, schedulers, and the billing department of any services requested and/or referred that are not authorized by insurance.
What will you do?
- Obtain pre-authorization for infusions, procedures and treatments being provided prior to patient appointments.
- Verify patient insurance information is accurate and documented correctly.
- Investigate, report and analyze patient CPT codes not originally noted in the CPTN at the onset of the pre-authorization process.
- Review and resolve all reported authorization issues timely and effectively.
- Communicate authorization, and any financial and benefit coverage with patients and providers timely and professionally.
- Obtain appropriate documentation to validate the approval or denial of authorizations.
- Maintain patient file security and confidentiality by adhering to appropriate confidentiality and HIPPAA policies and guidelines.
- Advise management of identified trends with payers in an effort to minimize problems.
What do you need to be?
- Able to organize workload and manage time effectively
- Able to establish and maintain effective working relationships with patients, management, employees, and the public.
- Technologically savvy
- Able to read and interpret medical benefits for verification requests.
- Able to handle a high volume of work with speed and accuracy
What do you need to have?
- High school diploma or equivalent
- Experience in a health care setting required
- ICD-10 and CPT knowledge required
- Proficiency in MS Office
- Comprehensive understanding of authorizations required
*Note: Compensation may fluctuate slightly based on the candidate's geographic location / cost of living index, etc.
Job Type: Full-time
Pay: $20.00 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Education:
- High school or equivalent (Preferred)
Experience:
- prior authorization: 1 year (Preferred)
- Infusion: 1 year (Preferred)