40 hrs/wk; 8:30a-5p, 5 days/wk. Team member will work closely with clinical and billing team to ensure timely and accurate processing of prior authorization requests to support patient care and optimize reimbursement. Provides support to the revenue cycle by initiating, monitoring, and ensuring appropriate prior authorization of CPT(s) for upcoming diagnostic testing. surgical and cardiology procedures, medications, referrals and follow-up care is completed; will follow-up on denials when necessary. Will utilize phone and online payor portals with multiple insurance carriers, Medicare and Medicaid. Effective use of communication and collaboration with patients, providers, clinic and OR staff. Documentation in the electronic medical record (EMR) all authorization activity and status. Maintain up-to-date knowledge of payer policies and authorization guidelines. Assist as needed with Clinic Receptionist duties and assignments as delegated by the Practice Manager. Experience with prior authorizations in a specialty clinic. Knowledge of Medicare, Medicaid, and commercial insurance plans. Proficiency in EMR systems, payor portals, Microsoft Office. Must be organized and detail oriented.
Provided by company| Date Posted | October 30, 2025 |
|---|---|
| Date Closes | November 29, 2025 |
| Located In | Columbus, NE |
| Job Type | Full-time Employee |
| Compensation | Salary, Varies |
| Shift | Custom |
| SOC Category | 43-4051.03 Patient Representatives |
| Zipcode | 68601 |
This job is related other jobs in these career categories