Prior Authorization Specialist (Remote after training)

DeCoach Recovery; Cincinnati, Northern (OH, KY); Hybrid; USD 40,000 - 64,000; Full time

Benefits offered by this job

Medical, Dental and Vision Benefits

A Company Matched 401(k) plan

Tuition Reimbursement

STAR Eligible Facilities to Assist in

Job summary

DeCoach Recovery is hiring a Prior Authorization Specialist to join our Sharonville-based team in Cincinnati, OH. In this role you will review clinical documentation, obtain approvals from insurance providers, and communicate with payers to ensure coverage requirements are met.

The position offers competitive benefits and room for professional growth. After completing training, the role may transition to remote work, with ongoing responsibilities including tracking requests, resolving denials,

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

Skills

Prior authorization experience

Communication skills

Negotiation skills

Education

High school diploma or equivalent

Associate or Bachelor's degree preferred

Tools

Microsoft Office Suite

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Cincinnati, OH, US

DeCoach Recovery is a leading addiction treatment center dedicated to providing compassionate care and effective solutions for individuals battling addiction. We take the time with every client to understand their needs and where they are on their recovery journey to help them not only reach sobriety, but to stay sober long-term.

We are currently hiring for a prior authorization specialist to work at our Sharonville Headquarters. You will be responsible for obtaining necessary approvals from insurance providers prior to patients starting treatment or medications. You will review clinical documentation, submit authorization requests, and communicate with healthcare providers and payers to ensure coverage requirements are met. The role includes tracking requests, resolving issues and denials. This position can become remote once training is completed.

Minimum 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

• Medical, Dental and Vision Benefits


• A Company Matched 401(k) plan


• Tuition Reimbursement


• STAR Eligible Facilities to Assist with Student Loan Forgiveness