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Reimbursement Specialist, Prior Authorization
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Job Description
- Req#: 744000003488535
Employer Industry: Precision Oncology
Why consider this job opportunity:
- Salary up to $27.31 per hour
- Hybrid work model providing flexibility for better work-life balance
- Opportunity for career advancement and growth within a dynamic organization
- Supportive and collaborative work environment focused on patient outcomes
- Chance to make a positive impact in the field of cancer care and reimbursement processes
What to Expect (Job Responsibilities):
- Contact insurance companies to secure preauthorization required for patient services
- Develop and maintain a database of payer authorization requirements
- Manage documentation for payer communication, correspondence, and insurance claim research
- Troubleshoot EOBs and appeal non-covered or inappropriately adjudicated claims
- Track, report, and address complex outstanding claims to drive positive coverage determinations
What is Required (Qualifications):
- Minimum of three years of work experience in a healthcare environment focused on healthcare reimbursement
- Strong attention to detail and ability to work with minimal supervision
- Moderate Excel skills, including sorting, filtering, and performing simple calculations
- Experience coordinating with insurance providers, physicians, and patients for prior authorizations
- Familiarity with laboratory billing and payer portals is a plus
How to Stand Out (Preferred Qualifications):
- Experience appealing to state-level agencies or external review organizations
- Knowledge of health plan regulations and processes
- Previous experience with Xifin, EDI enrollment, and merchant solutions
#PrecisionOncology #HealthcareReimbursement #HybridWork #CareerOpportunity #CancerCare
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