Prior Authorization Specialist - Coverage & Denials Expert

DeCoach Recovery Centre; Cincinnati (OH); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, Dental and Vision Benefits

Company Matched 401(k) plan

Tuition Reimbursement

STAR Eligible Facilities to Assistwith

Job summary

DeCoach Recovery Centre is hiring a Prior Authorizations Specialist to manage insurance approvals before treatment or medications. The role is based at our Sharonville Headquarters in Cincinnati and involves reviewing clinical documentation, submitting requests, and communicating with providers and payers to ensure coverage requirements are met.

Minimum qualifications include a high school diploma (associate or bachelor’s preferred) and at least 2 years in prior authorizations or revenue cycle,

Qualifications

• High school diploma or equivalent; associate or bachelor's degree preferred.
• Minimum of 2 years experience in prior authorizations or in a revenue cycle role
• Excellent communication and negotiation skills.
• Proficiency with technology including Microsoft Office Suite.

Responsibilities

• Verify patient eligibility and coverage limits
• Review medical charts to ensure clinical notes match what insurance requires
• Send requests for prior approval to insurance providers
• Track pending cases and follow up with insurance agents

Job description

DeCoach Recovery Centre is hiring a Prior Authorizations Specialist to manage insurance approvals before treatment or medications. The role is based at our Sharonville Headquarters in Cincinnati and involves reviewing clinical documentation, submitting requests, and communicating with providers and payers to ensure coverage requirements are met.

Minimum qualifications include a high school diploma (associate or bachelor’s preferred) and at least 2 years in prior authorizations or revenue cycle,