Rev Cycle Specialist (Prior Authorizations) en PRISM Vision Group
PRISM Vision Group · New Providence, Estados Unidos De América · Hybrid
- Professional
- Oficina en New Providence
Role and Responsibilities:
- Identifies all appointments and procedures that require prior-authorization by monitoring system reports
- Reviews patient diagnoses and medical notes/laboratory reports required for prior-authorizations submissions
- Accountable for knowledge of updated drug and procedure prior-authorization requirements, relating to all commercial insurance carriers
- Communicates with Insurance carriers by phone for cases of urgency, down systems, research/clarifications or troubleshooting
- Independently maintains and updates multiple reports on all upcoming patient appointments and prior-authorizations
- Maintains patient confidentiality
- Utilizes insurance portals to submit prior-authorizations
- Troubleshoots prior-authorization cases for insurances
- Manages a high-volume demand for prior-authorizations with accuracy
- Attends and participates in NJ Retina / or payer meetings/seminars as needed
- Maintains open, positive cordial, team-oriented lines of communications with managers and staff members
- Contributes to the Business office team thought, positive attitude, respectful interaction, innovative ideas and efficiently
- Other duties as assigned
Essential Qualifications:
Education: High School Diploma or equivalent; Bachelor’s degree preferred.
Experience: 1+ years’ experience in an administrative role; medical billing experience within Ophthalmology preferred but not required.
Knowledge/Skills/Experience:
- Working knowledge of prior-authorization process
- Experience with Medicare, insurances, claims, appeals
- Knowledge of CPT, ICD-9 and/or ICD-10 codes a plus
- Proven customer service skills
- Able to work in a high volume/fast-paced environment
- Excellent written and verbal communication skills
- Outstanding attention to detail and excellent time management skills
- Outstanding typing and computer skills with billing software, Microsoft Word and Microsoft Excel
- Ability to work with sensitive and confidential information
Hourly Pay Range-
$21.8500 to $25.00 USD
At PRISM Vision Group, we believe great work deserves great rewards. Here’s what you can expect when you join our team:
- Competitive Compensation – Base salary, performance bonuses, and regular reviews.
- Health & Wellness – Comprehensive medical, dental, and vision insurance; and wellness program.
- Retirement Planning – 401(k) with company match.
- Generous Time Off – Paid vacation, sick leave, and company holidays.
- Learning & Development –career growth programs.
- Other Perks – Commuter benefits, Voluntary Accident and Critical Illness plans, FSA/HSA and Dependent Care FSA. employee discounts, and more.