Prior Authorization Specialist

For over 20 years Riverhills Neuroscience has been the region's premier provider of comprehensive neuroscience care by offering a complete diagnosis, education, treatment and rehabilitation services for individuals with the diseases and injuries of the nervous system. Job Overview for Medical Billing Specialist - Prior Authorization Responsible for verification and investigation of pre-certification, authorization, pre-determination and/or referral requirements for services. Coordinates and supplies information to the Insurance Payer/review organization including medical information and/or letter of medical necessity for determination of benefits. Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review. Communicates with patients, clinical partners, and other employees to facilitate authorization process. Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. Completes accurate and timely documentation in the EMR. Ensures timely and accurate insurance authorizations are in place prior to services being rendered. Follows policies and procedures when necessary authorization is not obtained prior to service date. Answers provider, staff, and patient questions surrounding insurance authorization requirements. Background and Experience for Medical Billing Specialist - Prior Authorization 1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice required Experience with an Electronic Medical Record (EMR) and practice management system required Knowledge of Medicare/Medicaid and major insurance carrier's guidelines Working knowledge of OCD-9 / CPT medical coding and billing Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors Must understand medical terminology Benefits for Full Time Employees: 401k with Profit Sharing and Company Match Medical, Dental, and Vision insurance Long Term and Short Term Disability Insurance Life Insurance Paid Holidays 3+ Weeks of Paid Time Off Continuing Education Reimbursement Uniform Allowance Free Parking If you are interested in becoming part of a world-class healthcare team, please apply today. Equal Opportunity/Drug Free Work-place