Pre Authorization Specialist - Remote / Telecommute

Cynet Systems • Marlborough, MA, US • $21 - $26 / hour • 5m ago

Job Description:

Pay Range $21.83hr - $26.83hr

Responsibilities:

Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service.
Create electronic folders for new patients.
Organize patient medical records in preparation for prior authorization and appeals process.
Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling.
Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers.
Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome.
Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases.
Coordinates with lead and supervisor regarding complicated cases.
Build Quality into all aspects of their work by maintaining compliance with all quality requirements.

Qualifications:

High School Diploma.
Minimum 2-3 years of recent Insurance Pre-Authorization experience. Must have recent experience.
Experience working with various payors including, Medicare, Medicaid, and Private Payor, as it relates to medical procedures, services, and devices.
Experience building effective relationships with internal and external customers.

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