Reimbursement Specialist I - Prior Authorization - Remote

Overview

The Reimbursement Specialist I - Prior Authorization role is crucial for securing insurance preauthorizations and ensuring accurate billing operations to support cancer care.

In Short

• Act as a primary contact for obtaining insurance preauthorizations.
• Collaborate with billing and finance teams for timely payment processing.
• Maintain a database of payer authorization requirements.
• Manage documentation related to payer communication and claims.
• Track and resolve complex claims issues.
• Troubleshoot Explanation of Benefits (EOBs).
• Appeal non-covered claims as needed.
• Ensure compliance with third-party payer requirements.
• Support continuous improvement of billing processes.
• Work in a hybrid model with defined in-person and remote days.

Requirements

• 0-2 years of experience in healthcare.
• Strong understanding of health plan regulations and billing processes.
• Excellent organizational skills and attention to detail.
• Ability to work independently in a fast-paced environment.
• Proficiency in Excel.
• Preferred experience with insurance and payer relations.
• Knowledge of laboratory billing and EDI enrollment is a plus.
• Experience with claims appeals is a plus.

Benefits

• Flexibility in work-life balance through hybrid work model.
• Competitive hourly salary range.
• Opportunity to contribute to advancing cancer care.
• Supportive work environment with a focus on collaboration.
• Commitment to diversity and inclusion in hiring.