This is a fully remote position, open to applicants in Missouri.

📋 Description

• Participate in in-services offered by various health plans.

• Travel to off-site locations as required.

• Collect clinical information and manage referrals, pre-certifications, pre-determinations, and pre-authorizations in accordance with insurance plan guidelines.

• Record, track, and review managed care approvals and denials.

• Address last-minute or emergency referrals, additional procedure codes, and procedural modifications for pre-authorizations.

• Confirm insurance coverage and benefits.

• Generate price estimates and conduct reverifications as necessary, including first-of-the-month reverifications for managed Medicaid plans.

• Work collaboratively with insurance companies, providers, and staff to ensure compliance with plan requirements prior to the delivery of patient services and to optimize reimbursement.

• Carry out additional duties as assigned.

⛳️ Requirements

• High School diploma/GED or 10 years of relevant work experience.

• No prior experience is necessary.

• Must live within one hour of the job location.

• Regular use of a keyboard/data entry is expected.

• Ability to hear alarms, malfunctioning machinery, and other important sounds.

• Frequent lifting, carrying, and pushing/pulling of items weighing 0-25 lbs.

• Occasional lifting, carrying, and pushing/pulling of items weighing 25-50 lbs.

• Regular sitting, standing, walking, reaching, and repetitive foot/leg and hand/arm movements.

• Frequent use of vision and depth perception for both near and far tasks, as well as color identification and distinction.

• Regular use of hearing and speech for effective oral communication.

• Occasional bending, stooping, kneeling, squatting, twisting, and gripping.

• Rarely required to climb.

• No professional license or certification is necessary.

🏝️ Benefits

• Equal employment opportunities regardless of race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic safeguarded by applicable federal, state, or local law.