Hybrid Prior Authorization Specialist - Neuroscience Billing

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

Benefits offered by this job

401k with Profit Sharing

4% Company Match

Medical, Dental, Vision insurance

Disability Insurance

Life Insurance

Paid Holidays

Paid Time Off

Education Reimbursement

Uniform Allowance

Free Parking

Job summary

Riverhills Neuroscience is seeking a Prior Authorization Specialist to support the Billing department in Norwood. The role requires 1–2 years of medical billing and prior authorization experience, with EMR and insurance guideline knowledge.

The schedule is hybrid, with 2 days in-office and 3 days remote after training. Offered benefits include 401k with company match, comprehensive medical plans, paid time off, and education reimbursement.

Qualifications

• 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 EMR and practice management system.
• Knowledge of Medicare/Medicaid and major insurance carrier guidelines.
• Working knowledge of ICD-9-10 coding and medical terminology.
• Superior verbal and written communication skills are essential.

Responsibilities

• Streamline pre-certification, authorization, and referral processes to meet insurance requirements.
• Coordinate with insurance entities, reviewers, and clinical contacts for 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 manage authorizations for botulinum toxin procedures.
• Monitor schedules for insurance coverage changes and oversee specialty pharmacy orders.
• Educate patients about available assistance programs.

Skills

Verbal communication

Written communication

EMR experience

Medical billing

ICD-9-10 knowledge

Tools

EMR system

Job description

Riverhills Neuroscience is seeking a Prior Authorization Specialist to support the Billing department in Norwood. The role requires 1–2 years of medical billing and prior authorization experience, with EMR and insurance guideline knowledge.

The schedule is hybrid, with 2 days in-office and 3 days remote after training. Offered benefits include 401k with company match, comprehensive medical plans, paid time off, and education reimbursement.