Authorization Specialist

This is a fully remote position, open to applicants in Connecticut, +6 more states.

📋 Description

• Acquire and sustain prior authorization status for medications and therapies for NELC patients.

• Collaborate closely with the clinical review department to gather necessary documentation for completing authorization procedures.

• Secure documentation to assist the billing department in fulfilling payer requirements for patient accounts.

• Adhere to Authorization Request, Re-Authorization, and Specialty processes for all payers.

• Operate independently and proficiently on MOAs and therapies.

• Authorize all services while accurately documenting and communicating service changes in CPR+ to the relevant departments.

• Address TO DO items efficiently without prolonged delays.

• Exhibit precise, confident communication along with outstanding customer service.

• Uphold attendance, punctuality, performance, and compliance standards.

• Engage in professional development, LEAN initiatives, and/or leadership education programs.

⛳️ Requirements

• A minimum of three years of experience in authorization or billing (ideal candidate).

• At least 2 years of experience in authorization, reimbursement, or claims processing is required.

• High School Diploma or equivalent is mandatory.

• Practical knowledge of medical terminology is essential.

• Familiarity with CPT, ICD-9, and HCPC coding is preferred.

• Experience with Medicare, Medicaid, and third-party payer contracts is preferred.

• Understanding of HIPAA Privacy and Security regulations is preferred.

• Strong organizational skills are required.

• Basic skills in accounting transactions and analysis are necessary.

• Proven ability to identify, research, and resolve issues is required.

• Capability to work independently as well as collaboratively within a team is essential.

• Practical experience with Microsoft systems and applications, including Word and Excel, is required.

• Candidates must reside in Maine, Massachusetts, New Hampshire, Maryland, North Carolina, Connecticut, or Florida.

• Availability from Monday to Friday, 8:30am to 5:00pm is required.

🏝️ Benefits

• Remote position.

• Opportunities for growth and potential advancement.

• Health insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Generous employer-matched 403b savings program.

• Company-paid life insurance.

• Company-paid short- and long-term disability insurance.

• Paid time off.

• Three continuing education programs focused on professional development, LEAN, and/or leadership development.