Payer & Authorization Specialist

Trilogy Health Services, LLC; Kentucky; On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

Weekly pay

Health and dental after first month

Student loan repayment

401(k) match

Job summary

Trilogy Health Services in Louisville, KY is seeking a Payer Services Specialist to support the Director of Payer Relations and Auth Svcs. You will handle prior authorizations, recertifications, and insurance verifications for admissions and therapy services.

Responsibilities include educating campuses on eligibility, researching denials, and ensuring timely authorizations to minimize bad debt. This role emphasizes collaboration with the BOM and revenue cycle teams.

Qualifications

• High School diploma or equivalent.
• Bachelor’s degree or higher in accounting or business or related field preferred.
• Minimum of five (5) years healthcare insurance experience in healthcare, senior living, long-term care, or managed care.

Responsibilities

• Perform tasks in centralized eligibility, prior authorization intake, or recertification as delegated.
• Provide education on authorization, recertification, and benefit eligibility to campuses.
• Research denial issues related to eligibility or authorizations.
• Identify opportunities and troubleshoot problems in authorization or eligibility processes.
• Verify patient benefits, demographics, authorization requirements, network status, and financial information for reimbursement.
• Initiate online verifications or contact insurance carriers to validate benefits.
• Complete Preadmission Financial Verification prior to admission promptly.
• Communicate billing information and authorization requirements to campuses so claims can be billed accurately.
• Negotiate Single Case Agreements with managed care and other carriers when needed.

Skills

Healthcare insurance experience

Education

High School diploma or equivalent

Bachelor’s degree preferred in accounting or business or related field

Job description

Trilogy Health Services in Louisville, KY is seeking a Payer Services Specialist to support the Director of Payer Relations and Auth Svcs. You will handle prior authorizations, recertifications, and insurance verifications for admissions and therapy services.

Responsibilities include educating campuses on eligibility, researching denials, and ensuring timely authorizations to minimize bad debt. This role emphasizes collaboration with the BOM and revenue cycle teams.