Prior Authorization Specialist - DME & Billing

VieMed; Lafayette (LA); In loco; USD 38.000 - 48.000; Tempo pieno

Descrizione del lavoro

Ultipro in Lafayette, LA seeks an Insurance Verification/Prior Authorization Clerk for durable medical equipment. You will review records, obtain approvals, verify demographics and insurance, and coordinate with physicians' offices to ensure timely authorizations.

Responsibilities include responding to patient and insurer inquiries, maintaining compliance with Medicare/Medicaid policies, and communicating with Revenue Cycle leadership.

Competenze

• High School Diploma or equivalent.
• 2-4 years in DME or medical office experience preferred.
• Minimum 1 year of insurance verification or prior authorizations required.
• Knowledge of CPT/ICD-10, HCFA 1500, UB04 and HIPAA regulations.
• Familiarity with Medicare & Medicaid policies.

Mansioni

• Review and obtain necessary compliant documentation, medical records and prescriptions to submit for prior authorization.
• Obtain prior authorization from insurance payor for durable medical equipment.
• Verify patient demographics and health insurance information to review and work pending tasks daily for authorizations and/or appeals.
• Notify management regarding non-compliance and authorization deadlines.
• Establish and maintain effective communication with patients and physicians’ offices.
• Perform clerical tasks such as answering patient/insurance calls, faxing and emails.
• Communicate with Revenue Cycle Manager and Supervisor about concerns.
• Handle other responsibilities and projects as assigned.

Conoscenze

Superior organizational skills

Microsoft Office proficiency

Attention to detail

Written and oral communication

Formazione

High School Diploma or equivalent

Descrizione del lavoro

Ultipro in Lafayette, LA seeks an Insurance Verification/Prior Authorization Clerk for durable medical equipment. You will review records, obtain approvals, verify demographics and insurance, and coordinate with physicians' offices to ensure timely authorizations.

Responsibilities include responding to patient and insurer inquiries, maintaining compliance with Medicare/Medicaid policies, and communicating with Revenue Cycle leadership.