Prior Authorization Specialist

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, Colorado, +16 more states – Remote

🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌪️ Kansas – Remote 🦬 Montana – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ☕ Washington – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Logan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Logan Health is a healthcare system founded in 1910 that has been dedicated to providing exceptional care for over a century. Its main medical campus is located in Flathead County, serving a total service area that spans 13 counties, covering nearly 40,000 square miles and a population of more than 600,000. The system includes six hospitals, more than 50 provider clinics, and a variety of other healthcare services, notably including the nation's first rural air ambulance service (A. L. E. R. T. ).

📋 Description

• Obtain accurate prior authorizations for facility and professional charges related to scheduled patient appointments • Submit CPT and HCPCS codes and medical records to insurance carriers to expedite authorization requests • Verify patient demographics and medical information while ensuring HIPAA compliance • Review information accuracy and completeness and confirm supporting documentation • Collaborate with relevant stakeholders • Prioritize incoming authorization requests according to department procedures • Confirm CPT and ICD-10 diagnosis accuracy in procedure orders • Maintain intranet resources related to payer requirements • Contact patients and/or clinics when authorization is not obtained before the date of service • Initiate retro authorization requests and resolve authorization denials • Prepare, submit, and track appeals • Document all actions taken in patient accounts • Communicate billing, authorization, insurance, backlog, problematic account, and documentation issues to leadership • Adapt to changing circumstances to support patient flow • Maintain professionalism, integrity, confidentiality, and accurate attendance

🎯 Requirements

• Minimum of two (2) years’ experience in an acute care hospital, specialty clinic and/or medical billing office obtaining pre-certifications and/or prior-authorizations • Knowledge of commercial and government insurance requirements • Knowledge of medical terminology and rules and regulations governing the handling of private health information • Working knowledge of ICD-9 and CPT codes • Understanding of reimbursement and claims procedures and their direct impact on the revenue cycle • Working knowledge of Microsoft Office Suite and ability to learn other software as needed • Excellent verbal and written English communication skills • Excellent organizational skills, attention to detail, critical thinking, and ability to set priorities • Ability to function independently and as part of a team • Excellent interpersonal skills and ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy • Must reside in Arizona, Arkansas, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Michigan, Missouri, Montana, Minnesota, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, or Washington • Associate or Bachelor’s degree preferred • Meditech experience preferred • Knowledge of managed care coverage and medical coding preferred

🏖️ Benefits

• Comprehensive benefits • Opportunities for professional growth • Full-time remote work • Pre-employment screening includes criminal background check, reference checks, drug screening, health and immunizations screening, and physical demand review/screening