Prior Authorization Specialist Metrolina Nephrology Associates - 3.1 Charlotte, NC Job Details Full-time 1 day ago Benefits Wellness program Health savings account Disability insurance Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Employee discount Life insurance Qualifications Practice management Revenue cycle management Microsoft Outlook Presentation software Word processing Medical office experience Medical claims processing software Records management Electronic health record (EHR) management for billing and coding Full Job Description Metrolina Nephrology Associates is the region's most recognized and experienced nephrology group. The practice has been on the forefront of the treatment and management of kidney disease for more than 40 years. Composed of 41 Nephrologists and 44 Nephrology Advanced Practice Providers, our practice serves patients from eight convenient locations. Our extensive network of providers and offices allow our practice to deliver care in an atmosphere that is personal, patient centered, and compassionate. Job Summary To obtain timely and accurate prior authorizations for prescribed medications, procedures, and services by working with insurance providers, healthcare professionals, and patients to ensure uninterrupted access to medically necessary care while maintaining compliance with payer and organizational guidelines. Responsibilities Prior Authorization Processing Process and submit prior authorization requests within 24-48 hours of receiving complete clinical documentation throughout the evaluation period. Maintain documentation accuracy by ensuring all authorization records, payer communications, and supporting documents are complete and entered into the Electronic Health Record (HER) on the same business day. Work Queue (WQ) Management Monitor and manage work queues daily to identify expiring, pending, or incomplete authorizations. Hospital Authorization Management Coordinate authorizations for pheresis procedures and hospital services while maintaining communication with hospital staff and providers. Requirements 2 years in Medical Revenue Cycle, private practice preferred. Revenue Cycle Management or Certified Professional Coder certifications preferred but not required. Knowledge of physician office practice operations and organizational policies, procedures, systems and objectives. Knowledge of physician revenue cycle, patient collection rules and guidelines. Proficient in Word, Excel, PowerPoint, Outlook. Intense experience with Electronic Health Records (EHR) and Practice Management Systems. Competent in Electronic Health Records (EHR) software, able to use payer websites, Claims Clearinghouse, and any other technology related to medical office Revenue Cycle. Due to the nature of this position, before and after-hours work will be required on an as needed basis; that can include before 8:00am, after 5:00pm and occasional weekends. Regular, reliability, and punctual attendance is an essential function of this position. The ability to consistently adhere to scheduled work hours and fulfill job responsibilities in a timely manner is critical to the success of the role and the overall operations of the team.

Expected hours:

40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Vision insurance Wellness program Application Question(s): What are your salary requirements?

Work Location:

In person