Prior Authorization Specialist Tier 2

Medical Service Company; Cleveland (OH); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive Pay

HSA Account w/Company Contribution

Pet Insurance

Company provided Life and AD&D

Short-Term and Long-Term Disability

Tuition Reimbursement Program

Employee Assistance Program (EAP)

Employee Referral Bonus Program

Social Recognition Program

Employee Engagement Opportunities

CALM App

401k (with a matching program) / Roth

Company Discounts

Payactiv/On-Demand Pay

Paid vacation, Sick Days, YOU (Mental

Health) Days and Holidays

Job summary

Medical Service Co. in Ohio is seeking an experienced PAR specialist to join our revenue cycle team. This full-time hybrid role requires hands-on renewal authorizations, insurance verifications, and timely resubmissions across multiple payers.

Work in our offices on Tue-Thu with remote capability on other days, and enjoy comprehensive benefits, tuition reimbursement, and competitive pay. Minimum 3 years' healthcare revenue cycle experience is preferred.

Qualifications

• Minimum 3 years of revenue cycle experience in healthcare.
• Experience with prior authorizations and insurance verification is required.
• Knowledge of HME/DME industry is preferred.

Responsibilities

• Initiates renewal authorization requests with insurance companies and government payers.
• Monitors outstanding renewal authorization requests and follows up timely.
• Manages all held revenue related to prior authorizations for insurances assigned.
• Handles all claim denials due to missing prior authorization for insurances assigned.
• Maintains accurate and complete records concerning billing activity.
• Manages phone calls related to prior authorizations.
• Processes insurance changes when prior authorizations are needed.
• Communicates obstacles to PAR Supervisor/Manager.
• Serves as back up for prior authorization team tier 1.
• Other duties as assigned.

Skills

Revenue Cycle Experience

Healthcare Billing

Prior Authorizations

Insurance Verification

Detail-oriented

Education

High School Diploma or GED

Job description

We are looking for TOP PERFORMERS like you!

Location: Cleveland, Lewis Center, Toledo, OH

Job Id:2418

# of Openings:1

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).

MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!

MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.

In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!

We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!

• Competitive Pay
• HSA Account w/Company Contribution
• Pet Insurance
• Company provided Life and AD&D insurance
• Short-Term and Long-Term Disability
• Tuition Reimbursement Program
• Employee Assistance Program (EAP)
• Employee Referral Bonus Program
• Social Recognition Program
• Employee Engagement Opportunities
• CALM App
• 401k (with a matching program) / Roth IRA
• Company Discounts
• Payactiv/On-Demand Pay
• Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

As part of the PAR team, participates in monitoring and improving processes relative to the quality, appropriateness, and timeliness of the reimbursement information requirements of our order processing activities.

Reports To:

Manager, PAR

Responsibilities and Duties:

• Initiates renewal authorization requests with insurance companies and government payers.
• Monitors outstanding renewal authorization requests and initiates follow up of authorizations in a timely manner.
• Responsible for working all outstanding held revenue related to prior authorizations for insurances assigned.
• Handles all claim denials due to missing prior authorization for insurances assigned.
• Maintains accurate and complete records concerning billing activity.
• Manages phone calls related to prior authorizations.
• Training related to PAR processes
• Processes insurance changes when prior authorizations are needed.
• Communicates obstacles or challenges to PAR Supervisor/Manager that may lead to inaccurate or untimely resubmissions of claims.
• Serves as back up for prior authorization team tier 1.
• Other duties as assigned.

Qualifications:

Education: Graduate of an accredited high school or GED equivalence.

Experience/Knowledge/Skills/Physical Requirements:

• Minimum 3 years of revenue cycle experience in healthcare
• Ability to multi-task in a fast-paced environment
• Detail and team oriented
• Effective communication (verbal and written) and organizational skills
• Proven computer proficiency, the use of multiple applications simultaneously
• Previous experience in prior authorizations and insurance verification is required
• Knowledge of the HME/DME industry is preferred