Prior Authorization Specialist Tier 2

Medical Service Company; Cleveland, Lewis Center, Toledo (OH, OH, OH); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive Pay

HSA Account w/Company Contribution

Pet Insurance

Company provided Life and AD&D insu r

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

Job summary

Medical Service Company (MSC) is seeking a detail-oriented Revenue Cycle Specialist to support the PAR team. This full-time hybrid role requires working in-office on Tuesdays, Wednesdays, and Thursdays with remote work on other days, and includes benefits such as HSA, life insurance, and retirement plans.

You will initiate renewal requests, follow up on authorizations, resolve denials, maintain billing records, and coordinate with insurers to ensure accurate and timely reimbursements.

Qualifications

• Minimum 3 years of revenue cycle experience in healthcare.
• Ability to multi-task in a fast-paced environment.
• Detail- and team-oriented with strong organizational skills.
• Proficient with multiple software applications and systems.
• Experience with prior authorizations and insurance verification is required.
• Knowledge of the HME/DME industry is preferred.

Responsibilities

• Initiates renewal authorization requests with insurance companies and government payers.
• Monitors outstanding renewal authorizations and follows up in a timely manner.
• Manages held revenue related to prior authorizations for insurances assigned.
• Handles all claim denials due to missing prior authorization.
• Maintains accurate 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 to PAR Supervisor/Manager to avoid untimely resubmissions.
• Acts as back-up for PAR tier 1.

Skills

Revenue cycle experience

Multi-tasking

Attention to detail

Communication skills

Computer proficiency

Prior authorizations

Insurance verification

HME/DME knowledge

Education

High school diploma or GED

Job description

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!

Join Our Team

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