Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work in a supportive and collaborative environment
- Involvement in critical processes that impact patient care and revenue cycle management
- Chance to work with a dedicated team focused on improving patient outcomes
- Regular and consistent attendance expected, promoting a structured work-life balance

What to Expect (Job Responsibilities):
- Obtain accurate prior authorizations for facility and professional charges related to scheduled patient appointments
- Perform timely submission of CPT, HCPCS codes, and medical records to insurance carriers for prior authorization requests
- Ensure compliance with HIPAA regulations while securing patients' demographics and medical information
- Collaborate with stakeholders to review and confirm the accuracy of authorization requests and supporting documents
- Track and manage appeals for authorization denials and document all actions taken on patient accounts

What is Required (Qualifications):
- Minimum of two (2) years' experience in an acute care hospital, specialty clinic, and/or medical billing office obtaining pre-certifications and/or prior authorizations
- Knowledge of commercial and government insurance requirements, medical terminology, and privacy regulations
- Working knowledge of ICD-9 and CPT codes
- Understanding of reimbursement and claims procedures and their impact on the revenue cycle
- Excellent verbal and written communication skills, along with strong organizational and interpersonal skills

How to Stand Out (Preferred Qualifications):
- Experience with Meditech software
- Proven ability to manage sensitive situations with professionalism and diplomacy
- Critical thinking skills with the ability to prioritize tasks effectively
- Familiarity with the Logan Health intranet and payer requirements
- Ability to adapt to changing circumstances to meet patient flow needs

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.