Prior Authorization Specialist

Overview

ROMTech now seeks a Prior Authorization Specialist to join our billing team. The Prior Authorization Specialist is responsible for obtaining prior authorizations for all orders by successfully completing the authorization process with all commercial payers. The Prior Authorization Specialist will report to the Prior Authorization Supervisor. The ideal candidate is located in the NYC Metro area and has a keen attention to detail and is a team player.

Duties and Responsibilities

  • Conduct verification of benefits through insurance portal and phone calls
  • Check and obtain prior authorizations for the PortableConnect
  • Communicate with prescribing physicians’ offices to obtain missing documentation and other items
  • Prioritize incoming authorization requests according to urgency
  • Communicate with patients regarding their insurance benefits, coverage and authorization status of the device
  • Keep accurate and complete documentation of all calls conducted for each patient’s account
  • Provide the supervisor with a daily reporting account of completed work
  • Provide feedback to supervisor to help streamline billing/authorization efforts
  • Initiate appeals for denied authorizations
  • Confirm accuracy of CPT and ICD-10 diagnoses in the order
  • Other duties as assigned

Requirements and Qualifications

  • 2-5 years of prior-authorization experience
  • 2 years of experience in a medical related field
  • Proficient use of CPT and ICD-10 codes
  • Ability to understand authorizations and its direct impact on ROMTech’s revenue cycle
  • A self-starter with the ability to work independently as well as a team player
  • Attention to all the details, both big and small
  • Strategic thinker
  • Excellent customer service skills; communicates clearly and effectively
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Qualified candidates, please respond and include

  1. A cover letter detailing why you are the ideal fit for this job
  2. An up-to-date resume Pay

Candidates who send resumes without the requested cover letter will not be considered.

Finally, openness, honesty, and candidness are qualities we respond to—as opposed to framing things in the right way with the right words. Please be who you are and let the dice roll.

We are an equal opportunity employer. Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.