Riverhills Neuroscience
Prior Authorization Specialist - Infusion
Riverhills Neuroscience, Cincinnati, Ohio, United States, 45212
About Us:
For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.
Position:
Prior Authorization Specialist - Infusion Location:
Norwood Office Department
: Billing Schedule:
Hybrid upon completion of onsite training Key Benefits for Full-Time Employees: Competitive pay based on experience 401k with Profit Sharing and 4% Company Match Comprehensive Medical, Dental, and Vision insurance Long-Term and Short-Term Disability Insurance Company Paid Life Insurance Paid Holidays Over three weeks of Paid Time Off Continuing Education Reimbursement Uniform Allowance Free Parking Responsibilities: As Prior Authorization Specialist in Infusion at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include: Work proactively with practice physicians to identify patients as potential Infusion candidates. Ensure all patients are compliant w/individual criteria for both the drug manufacture and insurance company. Scan all relevant documents into EMR, such as enrollment forms, authorizations etc. Ensure insurance authorizations are approved and up to date. Coordinate with Infusion scheduler so patients are scheduled promptly. Determine procurement methods such as buy and bill or specialty pharmacy. Review policies on all major payers on a regular basis to check for changes on drug criteria and reimbursement. Save current policies on the Infusion drive. Research policies and reimbursement information on potential new infusion drugs. Demonstrate positive, proactive customer service to provide a pleasant environment for each patient. Assist in identifying and resolving insurance and/or assistance problems to ensure payment is received promptly. Maintain a monthly list of active and pending infusion patients. Follow up on pending patients' status regularly to move them along in the process. Address patient financial concerns and/or complaints and assist with resolution within the business day. Check voicemail and return patients' telephone calls within the business day. Check incoming faxes and distribute or handle as needed. Maintain patient assistance programs and ensure they are up to date. Communicate with all Pharmaceutical companies on patients' being started, discontinued, missing checklists, or overdue appointments. Coordinating delivery of infusion medications based on procurement method. Background and Experience: At least two to three years of experience in a healthcare setting with working knowledge of the prior authorization process. Experience in infusion prior authorization strongly preferred. Experience with an Electronic Medical Record (EMR) and practice management system is required. Working knowledge of ICD-9-10 medical coding and billing and medical terminology Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors. Ability to maintain strict confidentiality regarding patient and payer information. If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice. Equal Opportunity/Drug-Free Workplace: Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace. #IND4
Job Posted by ApplicantPro
Prior Authorization Specialist - Infusion Location:
Norwood Office Department
: Billing Schedule:
Hybrid upon completion of onsite training Key Benefits for Full-Time Employees: Competitive pay based on experience 401k with Profit Sharing and 4% Company Match Comprehensive Medical, Dental, and Vision insurance Long-Term and Short-Term Disability Insurance Company Paid Life Insurance Paid Holidays Over three weeks of Paid Time Off Continuing Education Reimbursement Uniform Allowance Free Parking Responsibilities: As Prior Authorization Specialist in Infusion at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include: Work proactively with practice physicians to identify patients as potential Infusion candidates. Ensure all patients are compliant w/individual criteria for both the drug manufacture and insurance company. Scan all relevant documents into EMR, such as enrollment forms, authorizations etc. Ensure insurance authorizations are approved and up to date. Coordinate with Infusion scheduler so patients are scheduled promptly. Determine procurement methods such as buy and bill or specialty pharmacy. Review policies on all major payers on a regular basis to check for changes on drug criteria and reimbursement. Save current policies on the Infusion drive. Research policies and reimbursement information on potential new infusion drugs. Demonstrate positive, proactive customer service to provide a pleasant environment for each patient. Assist in identifying and resolving insurance and/or assistance problems to ensure payment is received promptly. Maintain a monthly list of active and pending infusion patients. Follow up on pending patients' status regularly to move them along in the process. Address patient financial concerns and/or complaints and assist with resolution within the business day. Check voicemail and return patients' telephone calls within the business day. Check incoming faxes and distribute or handle as needed. Maintain patient assistance programs and ensure they are up to date. Communicate with all Pharmaceutical companies on patients' being started, discontinued, missing checklists, or overdue appointments. Coordinating delivery of infusion medications based on procurement method. Background and Experience: At least two to three years of experience in a healthcare setting with working knowledge of the prior authorization process. Experience in infusion prior authorization strongly preferred. Experience with an Electronic Medical Record (EMR) and practice management system is required. Working knowledge of ICD-9-10 medical coding and billing and medical terminology Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors. Ability to maintain strict confidentiality regarding patient and payer information. If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice. Equal Opportunity/Drug-Free Workplace: Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace. #IND4
Job Posted by ApplicantPro