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Rev Cycle Specialist (Prior Authorizations) en PRISM Vision Group

PRISM Vision Group · New Providence, Estados Unidos De América · Hybrid

45.448,00 US$  -  52.000,00 US$

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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.
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