Our client is making significant advances in food and health with new ideas and innovative technologies. We are seeking candidates with energy and enthusiasm to be part of our growing team throughout North America.
The role of the Reimbursement Authorization Specialist I is integral to the success of the Revenue Cycle Team. In direct hire role will be a patient-focused. You will serve as a liaison to assist customers (patients) with access to our clients medical foods and formulas through the referral process. This position is located in Ayer, MA with flexibility for hybrid schedule after training. The core hours of operation are 8:30 am to 5:30 pm.
Responsibilities include:
Ensure necessary documentation to start the referral process.
Contact healthcare professionals, state agencies, and payers (insurance companies) for clinical documents, eligibility, benefits, prior authorization, single case agreements, letter of agreements and any other items to ensure payment on an as needed basis (e.g., when authorization expires).
Assists in uploading current documents and populating required fields in Sales Force.
Ensures all incoming requests are worked and responded to timely, following the guidelines set forth within Revenue Cycle Department.
Provides assistance and guidance for patient(s) and their families working through eligibility, benefit verification and prior authorization process with payers.
Provides assistance and guidance for patient(s) and their families working through eligibility, benefit verification and prior authorization process with payers.
Provides excellent customer service resolving inquiries & issues in a timely, professional, and caring manner with compassion.
KNOWLEDGE, SKILLS, AND ABILITIES:
Proficiency in Microsoft Office; Excel, Word, Teams, etc.
Previous experience with SalesForce or Nexternal preferred but not required.
Ability to multi-task, with attention to detail to ensure accuracy.
Able to prioritize work, anticipate department needs, plan accordingly and able to handle the many interruptions with ease.
Strong written and oral communications skills required to provide excellent customer service and/or Revenue Cycle updates.
Team player
Must be results and people-orientated having the ability to balance business and relationship considerations.
Knowledge of HIPAA and the ability to maintain confidential information security relative to all company’s proprietary information.
EDUCATION, CERTIFICATIONS AND EXPERIENCE:
Minimum High School Diploma or equivalent; College degree a plus.
2 plus years work experience in medical billing, eligibility, authorization, and interaction with payers.
Understanding of HCPCs and ICD10 coding.
Working knowledge of commercial and state payers claim processing and procedures.