Hybrid Prior Authorization Specialist - Medical Billing

Riverhills Neuroscience; Cincinnati (OH); Hybrid; USD 25,000 - 30,000; Full time

Benefits offered by this job

Competitive pay

401k with profit sharing

Medical, Dental, Vision insurance

Long-Term and Short-Term Disability

Company Paid Life Insurance

Paid Holidays

Paid Time Off

Continuing Education Reimbursement

Uniform Allowance

Free Parking

Job summary

Riverhills Neuroscience is seeking a Prior Authorization Specialist for our Norwood Office in the Billing department. The role supports pre-certifications, referrals, and insurance communications in a hybrid schedule with two days in office and three days remote after training.

You will coordinate with insurers, perform benefits investigations, and manage authorizations for botulinum toxin procedures while ensuring accuracy, compliance, and strong patient service throughout the process.

Qualifications

• 1–2 years of medical billing and/or prior authorization experience in a healthcare practice.
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Responsibilities

• Streamline pre-certification, authorization, and referral processes to meet 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 and conduct benefits investigations, including botulinum toxin procedures.
• Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain ordering spreadsheets.
• Initiate patient education on available assistance programs.

Job description

Riverhills Neuroscience is seeking a Prior Authorization Specialist for our Norwood Office in the Billing department. The role supports pre-certifications, referrals, and insurance communications in a hybrid schedule with two days in office and three days remote after training.

You will coordinate with insurers, perform benefits investigations, and manage authorizations for botulinum toxin procedures while ensuring accuracy, compliance, and strong patient service throughout the process.