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360 Vascular Institute

Revenue Cycle & Prior Authorization Specialist

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$40,814 / year median in Ohio

-9% projected decline

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Job Description

Reports to: Revenue Cycle Manager Join a Growing Physician-Led Specialty Practice At 360 Vascular Institute, every team member plays an important role in our mission of delivering personalized, physician-led vascular care. We believe exceptional patient experiences begin with exceptional people. 360 Vascular Institute is the first nationally accredited independent Vascular and Interventional Radiology practice in Ohio committed to delivering exceptional, personalized vascular care. We are seeking an experienced Revenue Cycle & Prior Authorization Specialist to become an integral member of our growing team. This is more than a traditional medical billing position. You will work closely with physicians, nurses, and administrative leadership to help patients navigate insurance, obtain timely prior authorizations, resolve reimbursement issues, and support a seamless patient experience from scheduling through payment. This position reports directly to the Revenue Cycle Manager and plays an important role in the continued growth and success of our practice. Primary Responsibilities Obtain prior authorizations and referrals for office visits, imaging studies, and endovascular procedures Verify insurance eligibility, benefits, deductibles, and authorization requirements Manage insurance and patient accounts receivable Investigate and resolve denied, underpaid, and unpaid insurance claims Prepare and submit corrected claims, reconsiderations, and appeals Communicate with insurance companies regarding claim status and reimbursement Assist patients with billing questions and payment arrangements Maintain accurate documentation of all account activity Collaborate with physicians, clinical staff, and the Revenue Cycle Manager to improve reimbursement and patient access Cross-train in additional revenue cycle responsibilities as the practice continues to grow Required Qualifications Minimum 2 years of experience in medical billing, accounts receivable, prior authorizations, or revenue cycle operations Experience with insurance follow-up, denial management, and appeals Strong knowledge of Medicare, Medicare Advantage, and commercial insurance Excellent organizational, communication, and customer service skills Strong attention to detail with the ability to manage multiple priorities Proficiency with electronic medical record and/or practice management software Preferred Qualifications Experience obtaining prior authorizations for endovascular procedures strongly preferred Experience in Interventional Radiology, Vascular Surgery, or Interventional Cardiology Experience using Availity, payer portals, and specialty procedure authorizations Experience preparing appeals using clinical documentation and payer medical policies The Ideal Candidate We're looking for someone who is: Honest, dependable, and accountable Detail-oriented with exceptional follow-through A proactive problem solver who enjoys investigating complex reimbursement issues Compassionate and professional when working with patients Comfortable working independently while collaborating with a close-knit team Interested in growing with an expanding physician-owned specialty practice Why Join 360 Vascular Institute? Independent physician-led specialty practice Collaborative and supportive team environment Opportunity for professional growth and advancement Work directly with physicians and leadership Meaningful relationships with patients and coworkers Competitive compensation based on experience This position is primarily onsite. A limited hybrid schedule may be considered after successful completion of training and based on demonstrated performance, reliability, productivity, and the operational needs of the practice. Apply Today Please submit your resume along with a brief summary of your experience with: Medical billing and accounts receivable Prior authorizations Insurance appeals and denial management Patient financial counseling Endovascular or procedural specialty authorizations (if applicable)
Pay:
$20.00 - $25.00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Paid time off Retirement plan Vision insurance
Work Location:
In person