Location: Remote
Employment: Full-time
Position Overview:
ROMTech seeks a knowledgeable and organized Prior Authorization Specialist to join our growing billing team. The Prior Authorization Specialist is responsible for obtaining prior authorizations for all orders by successfully completing the authorization process with all commercial payers. This is a fulltime, remote opportunity reporting directly to the Prior Authorization Supervisor.
Duties & Responsibilities:
- Field incoming calls, texts, faxes and emails from patients, staff, and offices.
- Prioritize assigned tasks and work efficiently to maximize lead times and meet KPIs.
- Verify incoming clinical information to support coding.
- Verify insurance benefits and eligibility via telephonically and or online resources.
- Obtain prior authorizations from insurance companies as required.
- Review explanation of benefit breakdown with patients.
- Offer self-pay to patients with no insurance or denied coverage.
- Help specialists meet expectations held by the company.
- Use customer service skills to deescalate upset patients who do not understand our process.
- Implementation of organizational structure of everyday tasks for efficiency
- Providing support to the Field Clinicians for the understanding of the status in each process of the order.
- Utilizing the processes and meeting requirements for working an order from start to finish.
- Maintain assigned sites to department standards.
- Other duties as assigned.
Skills & Qualifications:
- Typing Skills: 60-70 WPM
- Strong computer knowledge (Microsoft Suite Products)
- Ability to work in a fast-paced environment.
- Ability to operate multiple systems for better efficiency.
- Proficient in time management.
- Knowledge of medical terminology, osteoarthrosis coding, HCPCS, ICD-10, office billing forms, insurance and governmental payer regulations and other third-party billing requirements preferred.
- Ability to work as a team.
- Punctual on deadlines given by leads/sales to ensure timely delivery.
- Ability to communicate with other departments of daily updates (intake/data/customer service)
- The ability to implement daily tasks based on company policies and procedures.
Requirements:
- 1-2 years recent experience in a related position.
- Must have prior experience working remotely.
- Understand all systems required to complete daily tasks: Dr Chrono, Ring Central, Slack, Odoo, ROMTea, UKG, PandaDoc, One Drive, Microsoft, etc.
- Certification preferred (CPB /CPC/CBCS/ CCS/CCA)
- Ability to sit at a computer terminal for an extended period.
- Moderate noise (i.e., phone calls, online meetings, computer audio).
- While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
- Specific vision abilities required by this job include close vision requirements due to computer work.
- Regular, predictable attendance is required.
If this sounds like an exciting opportunity to embark in the next chapter of your career, please respond and include:
- A cover letter detailing why you are an ideal fit for this job.
- An up-to-date resume
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing [email protected].
We are an equal opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status, or any other classification protected under applicable Federal, State or Local law.