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Prior Authorization Specialist

Riverhills Neuroscience
9 hours ago
Full-time
Remote friendly (Cincinnati, Ohio, United States)
Worldwide
$18 - $22 USD hourly
Registered Nurse
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: Monday-Friday, 8am-4:30pm, Hybrid: 2 days in office, 3 days remote.

Pay: $20+ per hour

Key Benefits for Full-Time Employees:

Competitive pay based on experience, minimum $20

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

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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