Pain Zero is a brand new Interventional Pain practice with two locations in the Columbus, Ohio area (Grove City and New Albany)! We are growing quickly, and are looking for an experienced Prior Authorization Specialist to join our team!
If you have experience with prior authorizations for imaging/procedures/surgeries, we would love to hear from you! Experience with pain practices, pediatric patients, operating rooms, and eClinicalWorks are added bonuses, but are not requirements.
Benefits of this role include paid training, fun work environment, five day work week, and opportunities for career advancement as our practice grows!
-Undertake a variety of financial and non-financial tasks in order to help guarantee the company's revenues. You will handle the processing of incoming payments along with the issuing of necessary paperwork.
-Processing of claims through electronic medical record.
-Has access to patient's charts to perform job functions listed below
-Covers all positions within department as needed.
-Shift times is 8am - 4pm, unless otherwise discussed.
-Covers teammates for breaks or as needed by management.
-Assists patients/caregivers with directions and misc. questions/typing patient cases/able to professionally deal with difficult individuals and able to professionally turn away patients as outlined by office policy.
-Provides exceptional customer services face to face and via phone queues.
-Speaks with patients regarding accounts, set up payment arrangements, resolve billing disputes.
-Updates patient information with changes in insurance/address information -Understands all aspects of HIPPA, Section 1557, Interpreter policy, Code of Conduct and Fraud.
-Understands the insurance websites and patient portal.
-Understands accepted insurances as outlined by office policy and covers queues as needed.
-Ready to work designated shift time with 30-minute lunch (unless another schedule is agreed upon with the manager in writing in advance)
-Report's absences/personal appointments/time off in advance
-Able to understand and follow policies and procedures.
-Able to change as the need warrants such change.
-Perform other related duties as assigned.
Prior Authorization Specialist Responsibilities
-Manages queue and voicemails daily along with current PA specialist
-Monitors and performs authorization for all patients which entails monthly reports, eligibility checks, updates code requirements, update insurance information, checks for mistakes and updates authorizations as needed.
-Submits authorization request for new, recheck and expired patients.
-Documents detailed cases of the authorization process for each patient.
-Contacts patients' insurance if authorization is ineligible, errored or as needed.
-Verifies scheduling accuracy and appropriate notes are placed.
-Schedules consults appropriately based on diagnosis.
-Schedules recheck appointments as needed.
-Confirms all advanced procedure appointments with patients including surgery centers.
-Assist clinical team as needed for administrative duties.
-Manages office deliveries in concert with staff for procedures at Main office.
-Documents detailed cases of deliveries processed for each patient and updates clinical staff of deliveries.
-Process other office deliveries daily
-Manages and works the billing bin in eCW as well as other projects directed by administration as needed.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job Type: Full-time
Pay: $18.00 - $22.00 per hour
Ability to commute/relocate:
Work Location: One location