Full-Time Senior Reimbursement Specialist - Prior Authorization

• Manage Prior Authorization Lifecycle: Independently handle the full prior authorization process.
• Optimize Billing Operations: Collaborate with the billing tool provider and internal teams.
• Resolve Reimbursement Issues: Spearhead efforts to address complex denials.
• Facilitate Communication: Work closely with ordering physician offices and internal teams.
• Maintain Accurate Documentation: Manage payer communications, correspondence, and insurance claims research.
• Develop Training & Quality Control: Contribute to the design and implementation of training programs.
• Collaborate with Offshore Teams: Work with Reimbursement management and offshore teams.
• Accurately enter and maintain data in computer systems.
• Verify and communicate insurance eligibility, billing and prior authorization details.
• Draft and submit written appeals.
• Interpret Prior Authorization Denials, Explanation of Benefits (EOBs).
• Adhere to HIPAA guidelines when providing medical records.
• Work effectively both independently and as part of a team.

• 5+ years recent experience in coding, billing, and prior authorization.
• Experience with contacting insurance carriers on denials.
• Experience working with a broad range of payers.
• Proficient using a computer, data entry, and have above average typing skills
• Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals and national payers.

What is the last date for applying to the job?

Which countries are accepted for this remote job?