Prior Authorization Specialist - Pain Management
PainPoint Health - Elgin, Illinois, us, 60122Work at PainPoint Health
Overview
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Overview
Compensation:
$19.00 - $22.00 per hourYour responsibilities will include:Monitor Advanced procedure trackers for each practice and identify opportunities to assist with the authorization process.Collecting all the necessary documentation to obtain prior authorization.Review medical necessity guidelines for all procedures by payorContacting the practice for additional information and completion of the required prior authorization in order to proceed with procedures and medication requestsComplete, timely, and accurate identification and submission of prior and retro authorization requests to the payorsInteracts with pain practices, vendors, insurance companies, patients, and management, as necessary, to request for prior authorizationsResponsible for documenting account activity, updating patient and claim information and demonstrating proficiencies with the prior authorization system to ensure all functionalities are utilized for the most efficient processing of claimsIdentifies prior authorization trends and/or issues resulting in delayed claims processing.Provides the highest level of customer service to internal staffServes as a backup to the Contact Center Team to receive inbound calls for patient scheduling as needed during peak hours of high call volume.Compensation PackagePerformance-based bonus incentivesAbility to work from home (remotely)A wide range of benefits including paid time off (PTO), 401k, medical, dental, vision insurance, and moreRespect and value of diversity, integrity, and teamwork.General DutiesPrior Authorization:Notify the provider offices on any delays with pending prior authorizationsCoordinate with the provider offices on any items needed to submit a timely prior authorizationStatus pending prior authorizations (electronically or via phone call)Submit prior authorizations in the approved systemInput prior authorization number into the EMR per policyCoordinate STAT or urgent prior authorization with the provider officeContact Center Team:Respond to patients via telephone by assessing needs and answering general questions regarding treatment optionsRegister and schedule new patients; send appropriate patient materials prior to initial appointmentMake appropriate scheduling changes, canceling, rescheduling and confirming appointmentsProvide excellent and timely customer serviceMaintain operations by following policies and proceduresTaking inbound calls to schedule new and existing patients for an assigned practiceRequirementsHigh School diploma/GED requiredProficiency with basic computer functions including mouse and keyboard usage, launching applications, conducting searches on the Internet, and maneuvering in a Windows-based environment strongly preferredCollaborative - You appreciate direct coaching/feedback to identify your strengths and opportunities for improvementAt least one (1) year of Prior Authorization experience is requiredBasic understanding of medical terminology (1) year in a clinical settingFamiliar with navigating payor portals to obtain authorization and medical policiesStrong organizational skillsBenefits Of Working At DxTx:100% Remote with great work/life balance cultureSafe Harbor 401(k) Match of 100% up to 3% and 50% of the following 2%Benefits With LOW $500 deductible for medical and great employer contribution!Employer Paid Life Insurance and Long-Term DisabilityFlexible PTO Plan for salary employees!Investment in professional development!Fun work culture with dedicated Culture Club!DAILYPAY AVAILABLE - Apply today and get paid as soon as you work your first shift!Job Type:
Full-timeCompensation:
$19.00 - $22.00 per hourBenefits:401(k)401(k) matchingDental insuranceHealth insuranceLife insurancePaid time offVision insuranceWeekly day range:Monday to FridayExperience:eClinicalWorks: 1 year (Preferred)ModMed: 1 year (Preferred)Prior Authorization: 2 years (Required)Work Location:
RemoteAn Equal Opportunity Employer
We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.