Prior Authorization and Collections Specialist

OBGYN & Midwifery of Connecticut • Manchester, CT, US • 5h ago

Women's Health CT is currently seeking a Part-time, Prior Authorization and Collections Specialist in Manchester, CT!

Position: Prior Authorization and Collections Specialist
Location: OBGYN & Midwifery of Connecticut
Address: 388 West Center Street, Manchester, CT 06040
Employment: Part-time, 24 hours per week
Schedule: Monday- Friday, flexible schedule
Reports to: Practice Manager

Job Summary: The Prior Authorization and Collections Specialist will obtain prior authorization for in-house and hospital procedures before scheduling, set up a budget plan when applicable, and obtain prior authorization, able to discuss balances and budget plans.

Position duties and responsibilities:

Communicate effectively on a continual basis with the Billing Manager with any issues that need to be addressed.
Review patient medical records to identify procedures requiring prior authorization.
Contact insurance companies to initiate the prior authorization process, providing detailed clinical information and justification for the procedure.
Follow up on pending authorization requests, addressing any queries from insurance companies promptly.
Monitor authorization status and communicate approvals or denials to the healthcare provider and patient.
Appeal denied authorization when medically necessary.
Contact patients with deductible and out of pocket cost to discuss payment options and arrange payment plans.
Review patient accounts to identify overdue balances and prioritize collection efforts before scheduling any appointments.
Document all attempts and patient interactions in the system.
Obtaining Insurance information from specific website: Availity
Assist with other insurance portals to gain coverage information
Additional administrative tasks, as needed.

Skills/qualifications:

Understanding of medical terminology, coding systems (CPT, ICD-10), and common medical procedures.
Ability to accurately verify patient insurance coverage and benefits.
Excellent verbal and written communication to effectively interact with patients, insurance companies, and healthcare providers.
Meticulous attention to detail to ensure accurate submission of prior authorization requests and collection data.
Ability to navigate complex situations and resolve billing issues with insurance companies and patients.

Qualified candidates are encouraged to apply to learn more about all the position has to offer!

The Job responsibilities provided are intended to be a summary of the job duties. In no instance should the duties, responsibilities, and requirements included in a job description constitute as being all-inclusive. The Company and authorized management personnel reserve the right to review, change, add and/or delete duties, responsibilities, and requirements on a job description as necessary.

Job Type: Part-time

Pay: $21.00 - $25.00 per hour

Expected hours: 24 per week

Benefits: