Prior Authorization Specialist - Medical Billing (Hybrid)

Chariot Leadership Services; Texas; Hybrid; USD 52,000 - 68,000; Full time

Benefits offered by this job

Hybrid work schedule

Job summary

Chariot Leadership Services in Texas is seeking a Senior Prior Authorization Specialist for a Medical Device client. The position starts as a contract and converts to permanent after 4 months, with a hybrid schedule and remote Mondays and Fridays.

The role involves verifying insurance, obtaining pre-authorizations, maintaining EMR documentation, and coordinating with physicians and payers to ensure timely testing and treatment.

Responsibilities

• This position includes verification of insurance benefits as it applies to the pre-certification process, obtaining pre-certification and pre-authorization from payers
• Collects and reviews all patient insurance information and submits prior-authorization form
• Authorization Specialist are responsible for all aspects of benefit verification and authorization
• Authorization Specialist ensure that NTINH meets patient’s insurance requirements for reimbursement prior to testing or treatment
• Obtains necessary pre-authorizations from payer
• Ensures up-to-date documentation on patient’s account in Electronic Medical Record related to authorization approvals and denials
• Maintains updated referrals and authorizations
• Communicates with ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician
• Contacts patient to notify of termed insurances
• Keeps current on insurance carrier requirements for testing and treatments provided at Texas Neurology
• Follows policy and procedures outlined by management to ensure standardization of processes across the clinics
• Unpacks and puts away medication - scans information into patient charts

Job description

Job Description

Our Medical Device client is seeking an Authorization Specialist for Medical Device claims.

This role will be start as a contract and go permanent after 4 months.

Hybrid Role with flexible hours - Monday and Fridays are remote

Senior Prior Authorization Specialist

• This position includes verification of insurance benefits as it applies to the pre-certification process, obtaining pre-certification and pre-authorization from payers


• Collects and reviews all patient insurance information and submits prior-authorization form


• Authorization Specialist are responsible for all aspects of benefit verification and authorization


• Authorization Specialist ensure that NTINH meets patient’s insurance requirements for reimbursement prior to testing or treatment


• Obtains necessary pre-authorizations from payer


• Ensures up-to-date documentation on patient’s account in Electronic Medical Record related to authorization approvals and denials


• Maintains updated referrals and authorizations


• Communicates with ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician


• Contacts patient to notify of termed insurances


• Keeps current on insurance carrier requirements for testing and treatments provided at Texas Neurology


• Follows policy and procedures outlined by management to ensure standardization of processes across the clinics


• Unpacks and puts away medication - scans information into patient charts