Reimbursement Specialist, Prior Authorization - Remote

Overview

As a Reimbursement and Prior Authorization Specialist, you will play a crucial role in securing insurance preauthorizations, streamlining billing operations, and ensuring accurate documentation to support cancer care advancements.

In Short

• Act as a primary contact for insurance preauthorizations.
• Collaborate with billing, finance, and client services teams.
• Maintain a database of payer authorization requirements.
• Manage documentation related to payer communication.
• Track and resolve complex claims.
• Troubleshoot Explanation of Benefits (EOBs).
• Appeal non-covered claims.
• Ensure compliance with Medicare and Medicaid requirements.
• Support continuous improvement in billing processes.

Requirements

• 0-2 years of experience in healthcare.
• Understanding of health plan regulations and billing processes.
• Excellent organizational skills and attention to detail.
• Self-motivated and able to work independently.
• Proficiency in Excel.
• Experience with insurance relations is preferred.
• Knowledge of laboratory billing is a plus.
• Experience with appeals processes is a plus.

Benefits

• Hybrid work model with defined in-office days.
• Flexibility for better work-life balance.
• Opportunities for professional growth.
• Comprehensive benefits package (not detailed).