North Texas Institute of Neurology & Headache has an opening for full-time Prior-Authorization Specialist working on pre certifications for infusions. This position includes verification of insurance benefits as it applies to the pre-certification process, obtaining pre-certification and pre-authorization from payers, and counseling patients regarding their financial obligation with regard to the testing/treatment being scheduled, etc.

Company is open to salary negotiation for candidates who possess exceptional skills and qualifications that align with the demands of this role

RESPONSIBILITIES:

• Collects and reviews all patient insurance information and submits prior-authorization form.
• Authorization Specialist are responsible for all aspects of benefit verification and authorization
• Authorization Specialist ensure that NTINH meets patient’s insurance requirements for reimbursement prior to testing or treatment.
• Obtains necessary pre-authorizations from payer.
• Communicates with physician/clinical staff any pre-certification or PA requirements by the patient’s insurance carriers.
• Ensures up-to-date documentation on patient’s account in Electronic Medical Record related to authorization approvals and denials.
• Works with specialty pharmacies as required by patient’s insurance carrier to set up order and delivery of medication.
• Maintains updated referrals and authorizations.
• Communicates with ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician.
• Contacts patient to notify of termed insurances.
• Keeps current on insurance carrier requirements for testing and treatments provided at Texas Neurology.
• Follows policy and procedures outlined by management to ensure standardization of processes across the clinics.

KNOWLEDGE /SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION:

• Previous experience in pre-authorization/pre-certification and processing of health insurance claims
• Knowledge of insurance and third party payers
• Previous Aprima (EMR) experience preferred
• Basic computer knowledge and keyboarding skills
• Medical terminology
• Excellent communication skills
• Excellent and professional customer service skills
• Strong organizational skills
• Detail-oriented
• Ability to multi-task and work well in a fast-paced setting
• Critical thinking skills and decisive judgment

We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, and Vision Plan, 401-k with a matching component, Life Insurance, and Wellness Programs. NTINH is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.
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Benefit Conditions:

• Waiting period may apply
• Only full-time employees eligible

Work Remotely

• No

Job Type: Full-time

Pay: From $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Experience:

• prior authorization: 1 year (Required)
• Insurance verification: 1 year (Required)

Work Location: In person