<p>Job Description</p> <p>Overview</p> <p>Schedule: Monday-Friday, 8:00 a.m. - 4:30 p.m.</p> <p>Work Arrangement: Hybrid</p> <p>Position Summary</p> <p>The role is responsible for the timely and accurate processing of prior authorizations. This includes obtaining authorizations and completing appeals within required timeframes. The position may also be responsible for identifying charging issues, troubleshooting problems, and developing solutions to ensure accuracy and compliance.</p> <p>Key Responsibilities</p> <ul> <li>Obtain prior authorizations in a timely and accurate manner. </li><li>Prepare and submit appeals as needed. </li><li>Identify, analyze, and resolve charging or billing issues. </li><li>Ensure compliance with payer rules, regulations, and documentation requirements. </li><li>Communicate effectively with internal teams, providers, and payers. </li></ul> <p>Top Skills Preferred</p> <ul> <li>Strong insurance knowledge </li><li>HCPCS coding experience </li><li>Experience with drug programs </li><li>Solid written and verbal communication skills </li></ul> <p>Required Qualifications</p> <ul> <li>High school diploma or equivalent. </li><li>Minimum of three (3) years of experience in hospital or physician billing. </li><li>Working knowledge of payer billing requirements and regulations. </li></ul>