Description:
Promptcare is seeking a highly motivated and detail-oriented Reauthorization Specialist to join our team. The Reauthorization Specialist will be responsible for obtaining and maintaining insurance authorizations for infusion therapy services. The ideal candidate will have experience in healthcare insurance and be able to work in a fast-paced environment. If you are a self-starter with a passion for healthcare and a desire to make a difference in patients' lives, we encourage you to apply for this exciting opportunity. To learn more about our company, visit us at PromptCare In-home Respiratory and Infusion
Job Type: Full-time, 40 hours per week, Mon-Friday 8:00am - 4:30pm (Flexible)
Location: Hybrid out of Lenexa, KS (open to remote)
Requirements:
High School Diploma or equivalent
Experience in medical office, patient contact and related experience required
Microsoft Office Suite experience required
Excellent oral and written communication skills are required to communicate with colleagues, management, patients, and physician offices
Medical Reimbursement background is preferred
CPR+ software or Caretend experience is desirable
Job Responsibilities, included but not limited to:
Initiate new and concurrent authorization requests to insurance payers for Home Infusion Therapy
Completes follow-up on pending and or expired authorizations
Review authorization approvals and denials for accuracy and initiate appeal process until the case is overturned, appeal options are exhausted, or a decision is made to discontinue the process
Documents details of all calls, faxed, and email communications in CPR+ software or Caretend per SOP of the department
Maintains documented record of approved/denied authorizations in the patients' chart for reference
Maintains strict confidentiality and adhere to HIPPA guidelines and regulations
Maintains a broad range of knowledge of insurance plan requirements, medical terminology, government regulation, and codes
Timely follow-up and response for all quality reviews
Work as a team player and shares knowledge gained per insurance updates ad communications with management and team members
Escalate problem accounts and ensure resolution
Regular contact with patients, insurance plans, physician offices and other personnel is necessary
Other duties as assigned by Intake Manager
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. Requires the ability to lift files, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies of 20 pounds but no more than 35 pounds.
Benefits & Perks
Comprehensive Medical, Dental, and Vision Package
401(k) Plan with Company Match
Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
Life Insurance: Standard coverage with optional enhancements
Employee Assistance Program: Free counseling and coaching sessions
Emotional Well-being and Work-Life Balance Resources
Short & Long-Term Disability: Company-paid with optional supplements
Accidental Death and Dismemberment Insurance
FSA and HSA: Manage healthcare expenses
Commuter Spending Programs
Employee Bonus Referral
Volunteer and Engagement Opportunities
Equal Employment Opportunity
The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.
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