<p>This is a remote US based position. It requires day time, week day hours (8 hour shifts Monday-Friday between 5am-11pm MST).</p> <p>Responsibilities</p> <ul> <li>Verifies patient insurance coverage timely utilizing phone or online resources. </li><li>Submit prior authorizations to insurances in timely matter via payer specific portals and vendors </li><li>Ensures all pertinent medical documentation is accurate and present prior to authorization submission. </li><li>Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval. </li><li>Communicates any authorization denials to the appropriate staff. </li><li>Handles any discrepancies, errors, or omissions of authorization denials and files appeals when necessary for overturn of adverse decision. </li><li>Participates in educational activities and attends regular staff and department meetings. </li><li>Exhibit and manage excellent turn-around time in order to ensure timely authorizations. </li><li>Consistently work in a positive and cooperative manner with fellow team members and management. </li><li>Demonstrate flexibility to perform duties wherever volume deems it necessary. </li><li>Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner. </li><li>Document activities appropriately in process notes. </li><li>Participates in the Quality Assurance plan. </li><li>Complies with applicable CLIA and HIPAA regulations. </li><li>Stay up to date with SOPS </li><li>Complies with all company and department policies and procedures </li><li>Contributes to a positive work and team culture </li></ul> <p>Qualifications</p> <ul> <li>High school diploma required. </li><li>3-5 years of experience working in medical billing, health insurance or collections with demonstrated results. </li><li>Insurance billing experience is preferred. </li><li>Good problem solving and decision-making skills. </li><li>Excellent customer service and phone skills. </li><li>Excellent time management, organizational, communication, multitasking and teamwork skills. </li><li>Working knowledge of ICD-10, CPT and HCPCS coding (preferred but no required). </li><li>Ability to successfully navigate between multiple systems throughout the course of the workday this includes but is not limited to billing software, written Standard Operating Procedures and payer portals. </li><li>Preferred authorization experience </li></ul> <p>Physical & Lifting Requirements</p> <ul> <li>Lifting Requirements - light work or exerting up to 20 pounds of force frequently. </li><li>Physical Requirements - stationary positioning, moving, operating, ascending/descending, communicating and observing. </li><li>Use of equipment and tools necessary to perform essential job functions. </li></ul> <p>#LI-Remote</p> <p>#LI-MH1</p>