Authorization Specialist

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Logo of New England Life Care

New England Life Care

201 - 500 employees

Founded 1987

New England Life Care is nationally recognized as a nonprofit, mission-driven home infusion therapy and specialty pharmacy services provider affiliated with 60+ of New England’s premier medical centers. We are a community-based organization with a charitable focus that our neighbors in Massachusetts, New Hampshire, Maine and Vermont rely on for the home infusion therapies they need to recover quickly in the comfort of their home.

📋 Description

• Obtain and maintain prior authorization status for NELC patient medications/therapies • Work closely with the clinical review department to obtain documentation needed to complete the authorization process • Obtain needed documentation to support the billing department in meeting payer requirements for patient accounts

🎯 Requirements

• At least three years of authorization or billing experience • High School Diploma or equivalent required • Minimum of 2 years authorization, reimbursement, or claims processing experience required • Practical experience with medical terminology; CPT, ICD-9 and HCPC coding preferred • Practical experience with Medicare, Medicaid and third-party payor contracts preferred • Knowledge of HIPAA Privacy and Security requirements preferred • Excellent organizational skills required • Basic accounting transaction/analyst skills required • Demonstrated ability to identify research and solve problems required • Ability to work independently as well as part of a team required • Practical experience with Microsoft computer systems and applications, to include Word & Excel

🏖️ Benefits

• Remote position • Room for growth and potential for advancement • Health insurance • Dental insurance • Vision insurance • Generous employer-matched 403b savings program • Company paid: Life insurance, Short- and long-term disability insurance • Paid time off • And much more!

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