Reimbursement Specialist - Prior Authorization - Remote

Overview

The Reimbursement Specialist plays a crucial role in securing preauthorization from insurance companies to ensure patients receive necessary services, while also managing documentation and optimizing billing processes.

In Short

• Drive payment by contacting insurance companies for preauthorization.
• Ensure accuracy and completeness of information obtained.
• Develop and maintain a database of payer authorization requirements.
• Manage documentation for payer communication and claims research.
• Track and report on outstanding claims.
• Troubleshoot EOBs and appeal non-covered claims.
• Coordinate with insurance providers, physicians, and patients.
• Work in a hybrid model with defined in-person collaboration days.
• Utilize moderate Excel skills for data management.
• Contribute insights and solutions to the team.

Requirements

• 3 years of experience in healthcare reimbursement.
• Knowledge of health plan regulations and processes.
• Experience with a broad range of payers.
• Ability to communicate effectively in complex scenarios.
• Familiarity with laboratory billing and payer portals.
• Strong attention to detail and organizational skills.
• Self-starter with minimal supervision required.
• Tech-savvy and analytical mindset.
• Experience appealing to state level agencies.
• Ability to work in a fast-paced environment.

Benefits

• Flexible hybrid work model for better work-life balance.
• Opportunity to work in a dynamic, fast-paced organization.
• Collaborative team environment.
• Access to advanced analytics and proprietary tests.
• Contribute to improving patient clinical outcomes.
• Competitive salary range.
• Equal opportunity employer.
• Support for candidates with disabilities.
• Confidential handling of applicant information.
• Access to career development resources.