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Pre Authorization Specialist I
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Job Description
- Req#: 616897
Employer Industry: Medical Device Company
Why consider this job opportunity:
- Salary up to $61,152
- Opportunity for career advancement and growth within the organization
- Work remotely with a flexible remote work model
- Supportive and collaborative work environment
- Access to the latest tools, information, and training to advance your skills and career
- Chance to make a meaningful difference in the health industry
What to Expect (Job Responsibilities):
- Answer incoming calls received through the Pre-Authorization Support ACD and provide appropriate call/case handling
- Perform benefit verification and pre-surgical authorization for new pre-surgical cases, and manage appeals by collaborating with payers
- Review payer denials and determine appropriate next steps according to payer appeal guidelines
- Utilize Microsoft Office and database management to document case status, actions, and outcomes
- Communicate and build relationships with healthcare professional offices and sales representatives regarding inquiries and case handling
What is Required (Qualifications):
- High School Diploma or equivalent
- Minimum 2 years of experience authorizing medical procedures/surgeries with commercial, Medicare, and worker's comp payers (pain management/spine preferred)
- Minimum 1 year of claim appeal experience
- Secure home office space with the ability to protect HIPAA sensitive materials
- Reliable high-speed internet connection
How to Stand Out (Preferred Qualifications):
- Experience in a call center environment
- Knowledge of healthcare insurance processes and payer systems
- Strong customer service skills
- Familiarity with medical terminology related to pain management and spine procedures
- Ability to suggest continuous process improvements
#MedicalDevice #RemoteWork #HealthcareCareers #CareerGrowth #CustomerService
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