Reauthorization Specialist

Beacon Hill - Job Details
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Reauthorization Specialist

Blawnox, Pennsylvania

|

Direct (Permanent) Full Time

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$ 19 - $ 24 per hour

Blawnox, Pennsylvania

Direct (Permanent) Full Time

$ 19 - $ 24 per hour

July 27, 2022

|

Job ID: A1300416pit_1658949597

July 27, 2022

Job ID: A1300416pit_1658949597

Job Summary

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Job purpose

The Reauthorization Specialist is an integral member of the reimbursement team and has primary responsibility for the timely initiation of reauthorizations with insurance carriers for established patients. The representative will also be in contact with the physician office and sales staff for additional clinical information, progress notes and additional testing when required.

Duties and responsibilities

  • Communicates medical need and educates case manager on LifeVest system to obtain authorization for services. Works with insurance carriers to authorize service for existing patients.
  • Negotiates favorable rates with insurance carriers to guarantee assignment of benefits and determine appropriate fee schedules for the billing process.
  • Obtains necessary documentation for continued authorization as dictated by payer, including updated clinical information or forms.
  • Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.
  • Completes weekly follow up with physicians or sales team to obtain updated clinical for existing patients. Interacts with sales staff as needed to obtain required documentation.
  • Responsible for generation of all reauthorization requests based on initial expiration.
  • Performs other duties as assigned by Management.

Qualifications

Qualifications include:

H.S. Diploma or equivalent required. Superior communication and customer service skills, and ability to handle multiple tasks simultaneously under strict deadlines.

  • H.S. Diploma or equivalent required.
  • 3-5 years' experience in medical insurance verification recommended
  • Strong negotiation skills.
  • Experience working with all payer types to include Medicare, Medicaid and third-party commercial insurance companies.
  • Superior communication, customer service skills and strong phone presence.
  • Ability to handle multiple tasks simultaneously under strict deadlines.
  • Proficiency in MS Excel, email programs and online data systems.
A1300416pit_1658949597

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About Beacon Hill

Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.

Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.

Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.

We look forward to working with you.

Beacon Hill. Employing the Future™