Senior Guest Eligibility & Authorization Specialist

RI International; Columbus (OH); Remote; USD 33,000 - 34,000; Part time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) retirement plan

Paid time off

Professional development

Job summary

RI International seeks a Guest Eligibility Specialist II to manage front-end eligibility and authorizations with greater independence. You will verify guest data, review clinical documentation, and initiate authorizations via payer portals or fax, ensuring accuracy and regulatory compliance.

The role emphasizes advanced coding knowledge, payer requirements, and proactive problem-solving, with responsibilities including training staff, improving workflows, and reducing denials.

Qualifications

• High school diploma or equivalent is required.
• 4+ years of registration and authorization experience.
• Knowledge of CMS guidelines, contracted insurance guidelines, and coding policies.

Responsibilities

• Register guests and manage authorizations across multiple states.
• Reconcile insurance coverage discrepancies and ensure demographic accuracy.
• Validate complex eligibility situations and escalate when needed.
• Apply advanced CPT/HCPCS/ICD-10 coding for authorizations.

Skills

Organized & detail-oriented

Multi-tasking

Microsoft Excel

HIPAA confidentiality

Professional communication

Education

High school diploma or equivalent

Job description

RI International seeks a Guest Eligibility Specialist II to manage front-end eligibility and authorizations with greater independence. You will verify guest data, review clinical documentation, and initiate authorizations via payer portals or fax, ensuring accuracy and regulatory compliance.

The role emphasizes advanced coding knowledge, payer requirements, and proactive problem-solving, with responsibilities including training staff, improving workflows, and reducing denials.