Prior Authorization Specialist

DeCoach Recovery is a leading addiction treatment center located in Sharonville, OH, dedicated to providing compassionate care and effective solutions for individuals battling addiction. We are seeking a detail-oriented and experienced Prior Authorization Specialist to join our team.

Job Overview:

We are seeking a detail-oriented and energetic Prior Authorization Specialist to join our team. In this vital role, you will manage the authorization process for various medical services, ensuring timely approval from insurance providers. Your expertise will help streamline patient care, reduce delays, and enhance overall satisfaction by navigating complex managed care protocols with precision and professionalism.

Key Responsibilities:

Review and prepare prior authorization requests for medical procedures, medications, and treatmentsVerify insurance coverage and eligibility through insurance verification processesAccurately code procedures using CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systemsMaintain comprehensive medical records and documentation in compliance with HIPAA regulationsCommunicate effectively with healthcare providers, insurance companies, and patients to facilitate authorization approvalsTrack and follow up on pending authorizations to ensure timely responsesStay current with changes in managed care policies, coding standards, and regulatory requirements

Qualifications:

Proven experience in managed care or medical office environments, preferably with prior authorization responsibilitiesStrong knowledge of medical terminology, medical records management, and medical coding (CPT, ICD-9, ICD-10)Familiarity with insurance verification processes and healthcare billing proceduresExperience working in dental or medical offices is highly desirableExcellent organizational skills with attention to detail and accuracyAbility to navigate HIPAA regulations diligently to protect patient confidentialityOffice experience demonstrating proficiency with electronic health records (EHR) systems or similar software

Benefits:

Competitive salary based on experience.

Medical, Dental, & Vision Heath InsuranceCompany Paid Life InsuranceAffiliated with the STAR program, assist employees in paying off student loansTuition Reimbursement programPaid Time-Off6 paid Holidays offOpportunities for AdvancementYearly Merit RaisesJoin our dedicated team at DeCoach Recovery and contribute to our mission of providing quality addiction treatment services while ensuring financial sustainability through effective revenue cycle management. If you have the required skills and experience, we encourage you to apply and become part of our compassionate and dynamic team. 8-4:30